Lead Health Policy Architect (Remote)

Intermountain Healthcare Inc.; Boise (ID); Remote; USD 43,000 - 67,000; Full time

Job summary

Intermountain Health is seeking a policy lead to guide the development and implementation of health plans policies that affect adjudication rules, benefit coverage, and provider reimbursement schedules. You will bridge policy concepts with operational practice across Select Health.

In this remote-friendly role, you will oversee policy implementation, coordinate with management, and stay current on changes affecting claims adjudication and benefits design.

Qualifications

• Four years of policy experience.
• Two years of experience in a medical benefits or insurance setting, or other related work experience to gain a good understanding of claims and eligibility issues, basic medical coding expertise, and insurance product knowledge.
• Experience managing projects that require strong interpersonal and organizational skills and the ability to perform under stress and to meet deadlines.
• Excellent oral, written, and interpersonal communication skills.
• Intermediate skills in computer-based word processing and spreadsheets

Responsibilities

• Leads the development and implementation of health plans policies and bridges the gap between policy and operational practice.
• Oversees the implementation of approved policy/product changes and coordinates the efforts of an implementation team.
• Stays current on changes, practices, policies, and all aspects of the business to provide accurate information about benefit quoting and proper adjudication.
• Oversees the coding review process, makes coverage and benefit determinations on each individual code.

Skills

Health Care Regulation

Communication

Project Management

Decision Making

Attention to Detail

Analytical Thinking

People Management

Cultivates Necessary Relationships

Initiative

Accountability

Education

Bachelor's Degree in a business or healthcare related field

Job description

Intermountain Health is seeking a policy lead to guide the development and implementation of health plans policies that affect adjudication rules, benefit coverage, and provider reimbursement schedules. You will bridge policy concepts with operational practice across Select Health.

In this remote-friendly role, you will oversee policy implementation, coordinate with management, and stay current on changes affecting claims adjudication and benefits design.