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)
Position Summary
The Policy and Government Affairs Manager is responsible for administering and maintaining policies and objectives involving local, state, and federal government affairs. Responsibilities include shaping and advocating for our Agency’s policy priorities and representing the Agency’s interests to government officials, legislators, regulators, and other key stakeholders. The Policy and Government Affairs Manager must have a deep understanding of policy issues, legislative processes, and governmental relations along with strong communication, strategic planning, and negotiation skills.
Required Education & Experience
An equivalent combination of training and experience that provides the required skills, knowledge, and abilities for this position may be considered.
Required Knowledge, Skills & Abilities
Essential Duties
Special Requirements, Licenses & Certifications
Working Conditions & Required Physical Abilities
Individuals in this type of position must have the use of sensory skills to effectively communicate with other employees and the public through the use of the telephone and personal contact as normally defined by the ability to see, read, talk, sit, stand, hear, use of fingers in order to handle, feel or operate objects and write. Must have the physical capabilities to move about the office and use and operate various office equipment; such as, but not limited to personal computer, calculator, copy and fax machines. It may involve extended periods of time seated at the keyboard or workstation. It may involve some lifting, carrying, pushing and/or pulling of materials and objects weighing up to 25 lbs.
Reasonable accommodations may be made to enable qualified individuals to perform the essential functions of the job.