Remote Health Policy & Programs Lead

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

Benefits offered by this job

Comprehensive benefits package

Job summary

Intermountain Health seeks a Policy Lead to drive health plan policy development, adjudication rules, and provider reimbursement schedules, linking policy concepts to operational practice in Select Health at Murray, Utah. The role oversees research, policy development, and implementation with senior management interactions, ensuring alignment with organizational goals and clinical input as needed.

The position requires policy experience, insurance knowledge, and strong project management,

Qualifications

• Four years of policy experience.
• Two years of experience in a medical benefits or insurance setting, or related to gain understanding of claims and eligibility issues.
• Experience managing projects requiring strong interpersonal and organizational skills under stress and deadlines.
• Excellent oral, written, and interpersonal communication skills.
• Intermediate skills in computer-based word processing and spreadsheets.

Responsibilities

• Leads the research process from initial policy development or modification through analysis and recommended policy.
• Develops policies with alignment to organizational goals, strategies, and clinical input as needed.
• Presents recommendations and answers questions about analysis and implementation impacts.
• Oversees implementation of approved policy or product changes and coordinates cross-functional teams.
• Provides support and acts as a resource for projects needing policy input.
• Stays current on changes, practices, and policies for accurate benefit quoting and adjudication.
• Oversees coding reviews and makes coverage decisions; implements changes.
• Champions and leads policy change initiatives.
• Participates in committees to ensure consistent policy development.
• Assists in other product development activities and market research.

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 business or healthcare

Four years of project management experience in regulatory or insurance setting

Knowledge of claims adjudication systems

Job description

Intermountain Health seeks a Policy Lead to drive health plan policy development, adjudication rules, and provider reimbursement schedules, linking policy concepts to operational practice in Select Health at Murray, Utah. The role oversees research, policy development, and implementation with senior management interactions, ensuring alignment with organizational goals and clinical input as needed.

The position requires policy experience, insurance knowledge, and strong project management,