Remote Senior Health Policy Strategist

Intermountain Healthcare Inc.; Bismarck (ND); Remote; USD 43.000 - 67.000; Vollzeit

Benefits dieser Stelle

Benefits package

Zusammenfassung

Intermountain Health, Murray, Utah, is seeking a policy specialist to lead health plan policy development and adjudication rule implementation. You will bridge policy concepts with operational practice, oversee coding reviews, and coordinate cross-functional teams to deliver compliant policies.

You will stay current on policy changes, provide decision support for benefit quoting, and participate in research and analytics related to pharmacy/utilization management.

Qualifikationen

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

Aufgaben

• Leads the development and implementation of health plans policies and adjudication rules.
• Oversees the policy implementation process and coordinates with management and functional areas.
• Provides support and acts as a resource for projects needing policy input.
• Stays current on changes and provides accurate information about benefit quoting and adjudication.
• Oversees coding review, makes coverage determinations and implements changes via documentation and system setup.
• Champions policy changes and participates in cross-functional committees.
• Participates in other product development activities and project tracking.

Kenntnisse

Policy knowledge

Communication

Project Management

Decision Making

Attention to Detail

Analytical Thinking

People Management

Relationship Building

Initiative

Accountability

Ausbildung

Bachelor's Degree in business or healthcare related field

Jobbeschreibung

Intermountain Health, Murray, Utah, is seeking a policy specialist to lead health plan policy development and adjudication rule implementation. You will bridge policy concepts with operational practice, oversee coding reviews, and coordinate cross-functional teams to deliver compliant policies.

You will stay current on policy changes, provide decision support for benefit quoting, and participate in research and analytics related to pharmacy/utilization management.