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Results for "Medical Policy"

2 gigs found around $100 across all platforms

AllDesign & CreativeDesign & Creative83Development & TechDevelopment & Tech509Writing & ContentWriting & Content22Marketing & SEOMarketing & SEO125Business & ConsultingBusiness & Consulting254Video & AnimationVideo & Animation7Music & AudioMusic & Audio
HimalayasView price

Client Policy Manager I

Overview The Client Policy Manager I manages client payment policies by ensuring client’s payment policy is accurate, up-to-date, and complete; executes client-specific requests with guidance from internal team and acts as the internal and external client team liaison. Responsibilities This position is client facing and requires a commitment to superior client service. Primarily responsible for the integrity of the client’s medical policy set, including awareness of all client-related Medical Policy project requests, monthly review of Max Units, review of Health Plan rules, etc. Primary driver of the Periodic Update analysis and industry updates. Review and identify changes needed to client policies in order to maintain up-to-date and accurate medical payment policies. Prepare payment policy documents for presentation to the client. Review all documents and coordinate reviews with Medical Directors and participate in client policy meetings. Conduct research and analysis for medical po

Client ServicesMedical PolicyClinical Coding
United States
3 days ago
HimalayasView price

Medical Policy Specialist II

Horizon Blue Cross Blue Shield of New Jersey empowers our members to achieve their best health. For over 90 years , we have been New Jersey’s health solutions leader driving innovations that improve health care quality, affordability, and member experience. Our members are our neighbors, our friends, and our families. It is this understanding that drives us to better serve and care for the 3.5 million people who place their trust in us. We pride ourselves on our best-in-class employees and strive to maintain an innovative and inclusive environment that allows them to thrive. When our employees bring their best and succeed, the Company succeeds. About the Role This position is responsible for the development and maintenance of Horizon Blue Cross and Blue Shield of New Jersey (HBCBSNJ) medical policy in conjunction with physician staff and the coordination of policy implementation with the Coding, Integration and NASCO/FACETS IT Teams including gathering and analyzing data to validate b

Medical PolicyHealthcare ComplianceUtilization Management
United States
5 days ago