Remote Health Policy Architect

Intermountain Health; San Juan (PR); A distancia; USD 43.000 - 67.000; Jornada completa

Descripción de la vacante

Intermountain Health is seeking a policy professional to lead health plan policy development and implementation. You will bridge policy concepts with operational practice across our health system and oversee coding determinations and benefits adjudication.

The role requires strong project management, organizational skills, and excellent communication. A bachelor’s in business or healthcare plus four years of policy experience are preferred, with a drive for process improvement and regulatory

Formación

• 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.

Responsabilidades

• Leads the development and implementation of health plans policies and helps define coverage for benefits.
• Bridges policy concepts with operational practice across Select Health.
• Oversees the policy implementation and coordinates the efforts of implementation teams.
• Provides support and acts as a resource for projects needing input from a policy specialist.
• Stays current on policy changes and informs benefit quoting and adjudication processes.
• Oversees coding review processes and implements coding determinations.
• Champions policy change initiatives and participates in cross-functional committees.
• Assists in other product development activities such as benefit design and market research.

Conocimientos

Health Care Regulation

Communication

Project Management

Decision Making

Attention to Detail

Analytical Thinking

People Management

Cultivates Necessary Relationships

Initiative

Accountability

Educación

Bachelor's Degree in business or healthcare

Four years of project management experience in regulatory or insurance setting

Descripción del empleo

Intermountain Health is seeking a policy professional to lead health plan policy development and implementation. You will bridge policy concepts with operational practice across our health system and oversee coding determinations and benefits adjudication.

The role requires strong project management, organizational skills, and excellent communication. A bachelor’s in business or healthcare plus four years of policy experience are preferred, with a drive for process improvement and regulatory