Medical Policy Manager jobs in Colorado

Medical Policy Manager manages and implements corporate policy and process for medical provider and other reimbursements. Ensures that all claims are reviewed, settled, and processed in compliance with and according to contract provisions and regulatory requirements. Being a Medical Policy Manager evaluates and develops policies and provider reimbursement guidelines to effectively manage and control medical claims cost. Requires a bachelor's degree of finance, business or healthcare administration. Additionally, Medical Policy Manager typically reports to head of a unit/department. The Medical Policy Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Policy Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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Manager, Public Policy
  • Colorado Hospital Association
  • Denver, CO FULL_TIME
  • The Manager, Public Policy is responsible for researching and analyzing public policy issues in the health care field, focused primarily on Colorado state agencies related to health care. The Manager, Public Policy identifies policy concerns, proposes solutions, makes recommendations, and implements policy positions and actions. This position publicly represents CHA and develops strong working relationships with government officials, CHA executive staff, CHA members, and other outside stakeholders. The Manager, Public Policy is responsible for strengthening the Association’s relationship and reputation with hospital administrators, government officials and other health care organizations in relevant public policy areas. 

     

    Essential Job Duties and Responsibilities:

    General:

    • Stay well-informed of current market trends, policy issues, and other developments affecting hospitals, health systems and health care and proactively identify recommendations based on opportunities and threats.
    • Deepen expertise in assigned focus areas, including working with members, other Colorado and national stakeholders, policymakers, and additional outside resources to create an informed perspective.
    • Ensure effective project management of a large number of regulatory and legislative projects, including issue tracking, risk management, communication management and evaluation.

    Policy Development & Advocacy:

    • In partnership with CHA leadership, develop and implement the Association’s objectives and strategies on priority policy matters such as behavioral health and environmental issues.
    • Secure the Association’s policy goals and agendas while negotiating with stakeholders and policy makers on regulatory or statutory changes, particularly in the areas of behavioral health.
    • Draft briefing memoranda, changes to legislation and regulation, talking points, fact sheets, testimony, progress reports, white papers, and other strategic communications consistent with the Association’s policy positions.
    • Determine the most effective and efficient means for proactively addressing proposed regulatory issues with state agencies (Department of Public Health and Environment, the Department of Regulatory Agencies, the Department of Health Care Policy and Financing, and the Department of Human Services and their federal counterparts), ensure necessary participation and input by members, and represent members’ views in public forums.

    Member Engagement, Stakeholder Relationships, Communication

    • Build, maintain, and grow strong working relationships with state policy makers, hospital administrators, subject matter experts, health care organizations and other key stakeholders
    • Ensure CHA policies are communicated with internal and external stakeholders with the highest level of professionalism, accuracy, and effectiveness
    • Ensure proposed public policies are effectively and adequately shared with members with a thorough analysis and potential positions or solutions
    • Actively collaborate, as appropriate, with the American Hospital Association, state hospital associations in the region and nationally, other relevant health care organizations, academic and business organizations
    • Represents CHA at business, stakeholder, community, fundraising, and other networking events

     

    Other Duties:

    • As assigned

    Supervisory Responsibilities:

    • None

     

    Knowledge, Skills and Experience required (unless otherwise noted):

    • Bachelor’s degree in social sciences, economics, public policy or political science, health care, business administration or related field (advanced degree preferred)
    • Minimum of five to eight years’ experience in policy research, program implementation, and stakeholder engagement with three years’ regulatory experience in health care or related area of public policy (preferably in Colorado or with Colorado stakeholders)
    • Experience with public policy research, data analysis and interpretation, and both objective and persuasive communications
    • Successful management of projects or programs with fixed deliverables
    • Demonstrated creativity and out-of-the-box thinking on policy issues
    • Knowledge of the unique issues facing hospitals and the broader spectrum of health care delivery and payment systems (preferred)
    • Knowledge of various health care payment systems and health care financing (preferred)

    Qualifications and Competencies:   

    • Strong attention to detail and accuracy
    • Demonstrated customer service orientation
    • Impeccable organizational skills and personable positive attitude
    • Strong written, verbal, and interpersonal communication skills
    • Ability to work well under pressure and within short deadlines
    • Analytical problem solving ability
    • Ability to handle sensitive situations with tact and diplomacy
    • Ability to handle confidential information and situations discreetly and professionally
    • Ability to work independently with limited supervision and to complete tasks on time
    • Self-starter with a strong desire to learn
    • Maintains prompt and regular attendance
    • Exceptional written and oral communication, including public speaking
    • Professional and diplomatic demeanor

     

    Physical Demands / Work Environment:

     

    The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

     

    • Working conditions are normal for a fast-paced office work environment.
    • Requires frequent day-travel within the Denver metro area and occasional overnight travel
    • Requires infrequent weekend and/or evening work.
    • Presentation of technical material in group settings required occasionally.
    • Individuals may need to sit or stand as needed.
    • Requires walking primarily on a level surface for periodic periods throughout the day.
    • May include lifting up to 25 pounds for files on a regular basis. Proper lifting techniques required.

    Material and Equipment Directly Used:

    • Cell phone
    • Personal computer with Microsoft Office software applications.
    • Multi-line telephone with voice mail.
    • Copy machine
    • Printer

     

    Hiring salary range: $70,000-85,000/year; eligible for benefits  

    The hiring salary range represents a targeted starting salary based on candidate’s experience, education, and/or skill level. The actual starting salary may be more or less depending on individual qualifications and does not represent the position’s full salary range.

     

    NOTE:  This job description is not intended to be an exhaustive list of all duties, responsibilities, or qualifications associated with the job.  The employee will be required to follow any other instructions and to perform any other duties requested by their supervisor.  Nothing in this job description shall create or is intended to create, or shall be construed to constitute a contract of employment, express or implied. Employees are held accountable for all duties of this job.

  • 3 Days Ago

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Workforce Innovation and Opportunity Act and Policy Manager
  • State of Colorado
  • Statewide, CO FULL_TIME
  • THIS POSITION IS OPEN TO CURRENT RESIDENTS OF COLORADO ONLY THIS ANNOUNCEMENT WILL REMAIN OPEN UNTIL 5:00 PM ON TUESDAY, JUNE 11TH, 2024 This position will have remote and hybrid workplace options ava...
  • 1 Day Ago

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Program Manager, Western Markets & Policy (Relocate to South Dakota or Colorado!
  • Black Hills Energy
  • Denver, CO FULL_TIME
  • Job Specifications As part of the Electric Utility planning and policy team this position is responsible for engaging in the design and development of western energy markets ensuring Black Hills' oper...
  • 1 Month Ago

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Policy Analyst
  • Commerce City
  • Commerce, CO FULL_TIME
  • The City of Commerce City is seeking a highly motivated Policy Analyst I, to join our growing and dynamic team! This position will support the City Manager’s Office (CMO) through the City Council Work...
  • Just Posted

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Policy Analyst
  • U.S. Department of the Treasury
  • Grand Junction, CO FULL_TIME
  • DutiesWHAT IS THE LARGE BUSINESS AND INTERNATIONALDIVISION?A description of the business units can be found at: https://www.jobs.irs.gov/about/who/business-divisionsVacancies Will Be Filled In The Fol...
  • 14 Days Ago

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Policy Analyst
  • U.S. Department of the Treasury
  • Fort Collins, CO FULL_TIME
  • DutiesWHAT IS THE LARGE BUSINESS AND INTERNATIONALDIVISION?A description of the business units can be found at: https://www.jobs.irs.gov/about/who/business-divisionsVacancies Will Be Filled In The Fol...
  • 15 Days Ago

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Hospital Medical Leader
  • Petco
  • Fairfield, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/10/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco
  • Deerfield Beach, FL
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Noblesville, IN
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/9/2024 12:00:00 AM

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Head of Medical Writing
  • Barrington James
  • Clinical-stage biopharmaceutical company in San Francisco, is seeking a Head of Medical Writing. This leadership role in...
  • 6/8/2024 12:00:00 AM

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Head of Medical Strategy
  • ExecuSearch
  • Atlanta, GA
  • The Head of Medical Strategy provides medical expertise to the rheumatology commercial and medical teams and provides cl...
  • 6/8/2024 12:00:00 AM

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Head of Medical Strategy Rheumatology
  • UCB
  • Atlanta, GA
  • Make your mark for patients The Head of Medical Strategy provides medical expertise to the rheumatology commercial and m...
  • 6/8/2024 12:00:00 AM

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Head of Medical Writing
  • Barrington James
  • San Francisco, CA
  • Head of Medical Writing - Rare disease Biotech We are currently partnered with a growing, west coast based biotech focus...
  • 6/7/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies, Inc.
  • Plainview, NY
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 6/7/2024 12:00:00 AM

Colorado (/ˌkɒləˈrædoʊ, -ˈrɑːdoʊ/ (listen), other variants) is a state of the Western United States encompassing most of the southern Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains. It is the 8th most extensive and 21st most populous U.S. state. The estimated population of Colorado was 5,695,564 on July 1, 2018, an increase of 13.25% since the 2010 United States Census. The state was named for the Colorado River, which early Spanish explorers named the Río Colorado for the ruddy silt the river carried from the mountains. The...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$134,084 to $163,689

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