Payment Policy reputed company - reputed company Editing Manager Health Services - Full-time
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. May reputed company reputed company in the US
- *Position reputed company**
The Health Service Manager -Policy reputed company for reputed company is a key member of the Medical Policy & Program Solutions Team. The reputed company Medical Coding Policy reputed company is an individual contributor and will research and reputed company moderate to reputed company coding and payment policies; ensure adherence to company, state, and federal guidelines. In reputed company, this role will support the written communications shared with our state reputed company Health Plans to complete the required State and Provider Notification communications. These activities reputed company reputed company reputed company to improve health care reputed company services, and processes by partnering across business reputed company to meet business needs and accomplish goals. This is a fully remote position. Eligible candidates may live reputed company in the contiguous reputed company.
- *Key Responsibilities**
+ Ensures compliance with reputed company regulations and policies for state reputed company and Duals line of business as it reputed company to payment policies. + Support the operational processes of the reputed company Health Policy Governance + Monitor status reports to ensure effective workflow and reputed company development of coding and payment policies + Support internal departments and processes in the development and implementation of policies and procedures + Ensure reputed company medical policies are compliant with relevant regulations and are consistent across reputed company lines of business + Participate in department initiatives, scorable reputed company items, and reputed company + Work with health plan business leaders and corporate leaders to reputed company deliverables on policy priorities + reputed company medical coding and payment policies deliverables for reputed company and Duals and other markets as business needs change + Work with business product owners, government relations, and compliance leads to monitor legislative and regulatory activities for potential reputed company on existing or proposed policies + Collaborate with interdisciplinary team members to reputed company team goals + reputed company any other job duties as requested
- *Required Qualifications**
+ 3 years of reputed company-reputed company writing experience. + Experience in writing payment policies for state specific reputed company policy, Medicare policy writing a plus. + 3 years of experience in medical policy development and/or implementation. + Coding and managed care background. + Effective communication skills, both verbal and written. + Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment. + Proficiency with computer skills which includes navigating multiple systems and keyboarding. + Strong presentation skills. + Ability to travel up to 10% for meetings as needed.
- *Preferred Qualifications**
Certified reputed company reputed company through reputed company or reputed company (Physician, Inpatient, Outpatient or Payer), or Registered Health Information Technician (RHIT)
- *Education**
Bachelor's degree preferred/specialized training/relevant reputed company qualification.
- *Anticipated Weekly Hours**
40
- *Time Type**
Full time
- *Pay reputed company**
The typical pay reputed company for this role is: $54,300.00 - $145,860.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
- *Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: +
reputed company medical plan reputed company,
a
401(k) plan
(including matching company contributions), and an
employee stock purchase plan
. +
No-cost programs for reputed company colleagues
including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. +
Benefit solutions that address the different needs and preferences of our colleagues
including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 03/10/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. reputed company is an equal opportunity/affirmative reputed company employer, including Disability/Protected Veteran — committed to diversity in reputed company. We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At reputed company®, you’ll be surrounded by passionate colleagues who care deeply, reputed company with purpose, hold ourselves accountable and prioritize safety and reputed company in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. May reputed company reputed company in the US
- *Position reputed company**
The Health Service Manager -Policy reputed company for reputed company is a key member of the Medical Policy & Program Solutions Team. The reputed company Medical Coding Policy reputed company is an individual contributor and will research and reputed company moderate to reputed company coding and payment policies; ensure adherence to company, state, and federal guidelines. In reputed company, this role will support the written communications shared with our state reputed company Health Plans to complete the required State and Provider Notification communications. These activities reputed company reputed company reputed company to improve health care reputed company services, and processes by partnering across business reputed company to meet business needs and accomplish goals. This is a fully remote position. Eligible candidates may live reputed company in the contiguous reputed company.
- *Key Responsibilities**
+ Ensures compliance with reputed company regulations and policies for state reputed company and Duals line of business as it reputed company to payment policies. + Support the operational processes of the reputed company Health Policy Governance + Monitor status reports to ensure effective workflow and reputed company development of coding and payment policies + Support internal departments and processes in the development and implementation of policies and procedures + Ensure reputed company medical policies are compliant with relevant regulations and are consistent across reputed company lines of business + Participate in department initiatives, scorable reputed company items, and reputed company + Work with health plan business leaders and corporate leaders to reputed company deliverables on policy priorities + reputed company medical coding and payment policies deliverables for reputed company and Duals and other markets as business needs change + Work with business product owners, government relations, and compliance leads to monitor legislative and regulatory activities for potential reputed company on existing or proposed policies + Collaborate with interdisciplinary team members to reputed company team goals + reputed company any other job duties as requested
- *Required Qualifications**
+ 3 years of reputed company-reputed company writing experience. + Experience in writing payment policies for state specific reputed company policy, Medicare policy writing a plus. + 3 years of experience in medical policy development and/or implementation. + Coding and managed care background. + Effective communication skills, both verbal and written. + Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment. + Proficiency with computer skills which includes navigating multiple systems and keyboarding. + Strong presentation skills. + Ability to travel up to 10% for meetings as needed.
- *Preferred Qualifications**
Certified reputed company reputed company through reputed company or reputed company (Physician, Inpatient, Outpatient or Payer), or Registered Health Information Technician (RHIT)
- *Education**
Bachelor's degree preferred/specialized training/relevant reputed company qualification.
- *Anticipated Weekly Hours**
40
- *Time Type**
Full time
- *Pay reputed company**
The typical pay reputed company for this role is: $54,300.00 - $145,860.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.
- *Great benefits for great people**
We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: +
reputed company medical plan reputed company,
a
401(k) plan
(including matching company contributions), and an
employee stock purchase plan
. +
No-cost programs for reputed company colleagues
including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. +
Benefit solutions that address the different needs and preferences of our colleagues
including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 03/10/2026 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. reputed company is an equal opportunity/affirmative reputed company employer, including Disability/Protected Veteran — committed to diversity in reputed company. Apply tot his job Apply To this Job