Medical Policy Manager jobs in Boulder, CO

Mesa County Department of Human Services is a forward-thinking agency that has over 300 employees serving the needs of nearly 40,000 residents. From the Colorado National Monument to the thriving agricultural lands and city centers, Mesa County contains a diverse, natural landscape that provides many outdoor activities and adventures. As individuals and an organization, we value and respect humanity, honesty, balance, inclusion and teamwork. We provide a level of flexibility for staff to be able to accommodate their lives outside of the office environment. We value family and the relationships that make our lives rewarding. 

Our Mission:  
The Mission of the Mesa County Department of Human Services is to help individuals and families achieve safety, stabilization and opportunity for meaningful employment.  

Our Values:  
Mesa County Department of Human Services values represent our behavioral anchors for how we conduct ourselves. Simply stated, we value Humanity, Balance, Honesty, Inclusion and Teamwork  
 

JOB SUMMARY:
This position is part of the Professional Standards Team within Mesa County Department of Human Services (MCDHS). This position will lead and perform complex data organization and programmatic analysis in an evolving data environment in order to plan, design and manage agency research projects relating to program evaluation within MCDHS, resulting in identification and recommendation of program performance to the Department's Leadership teams.  This position will compose and deliver training of program policy in an ever-changing program environment.  Performs quality assurance functions, and creates data collection efficiencies across all divisions within DHS.  Provides technical assistance to the agency through coordination and implementation of program/policy, development and implementation of databases, and design analysis of program data to ensure federal, state, and county compliance. Identifies opportunities for cross-divisional policy and program coordination as part of the agency's long-term goals to more strongly collaborate and integrate client services. In addition to very strong technical and statistical skills, this position requires superb business process analysis and interpersonal skills.

This position will collect, analyze and employ data to aid in evaluating programs, staff performance, and outcomes.  Will mine data, develop strategies to enhance data availability, quality, and usefulness to the Department, county, and state partners. Will interpret data using scientific methods to provide ongoing actionable insights and create high-level and in-depth reports and presentations. Educate requestors as to appropriate and desirable parameters to ensure they get the information they need.  Collaborates with end users to gather report requirements and ensure proper testing and validation.
   
Conducts policy and program research, analyzes policy, regulations, practice methods, and administrative data set.  Works directly with the Department's Leadership team, county and state partners to support policy implementation, and will contribute to the design and technical assistance of policy briefs and staff tools. Identifies problems/issues and develops policy revision proposal recommendations to the Department's Leadership teams for alternatives/solutions along with the feasibility of proposed changes as well as the positive or negative effects to the program.

Leads the Department in Assessing the programmatic, case management, and technical assistance needs of department staff and develops appropriate training to address those needs. Provides in-service training and one-on-one training to professional staff and administration on program, policy and technical aspects of program operations. Assembles and prepares aids (i.e., handbooks, guidance material, and desk aides) and conducts training for staff as needed to enhance program understanding and job performance.
   
Functions as a liaison and county advocate with State program experts.   Attends State training sessions and policy meetings.  Acts as program contact with partner agencies to provide and exchange program data and provide technical assistance as needed. Serves as a resource and consultant for other counties.
   
Develops program and case monitoring instruments and performs compliance audits.   Prepares written and oral summaries of findings and conclusions and then recommends corrective action to be taken.

Maintain up-to-date skills in the dynamic fields of data and policy analytics, and data visualization platforms; seek out continuing education, certification, and training opportunities;   continually improve strategies, tactics, and techniques; evaluate emerging technologies for policy and data analysis.

May serve as a designated Security Administrator or back up for access to all Colorado state computer systems including assignment of all access profiles, initial access authority, redetermination of access authority and revocation of access.  This includes all applicable state systems that are used. Serves as a liaison with the State Help Desk to log software or application problems.

Performs other related duties as assigned. 
 
 Guidelines, Difficulty and Decision Making Level:
   
 Guidelines are generally but not always clearly applicable, requiring the employee to exercise judgment in selecting the most pertinent guideline, interpret precedents, adapt standard practices to differing situations, and recommend alternative actions in situations without precedent.  Duties assigned are generally complex and may be of substantial intricacy. Work assignment is performed within an established framework under general instructions but requires simultaneous coordination of assigned functions or projects in various stages of completion.  Employee is responsible for determining time, place, and sequence of actions to be taken.   Unusual problems or proposed deviations from guidelines, practices, or precedents may be discussed with the supervisor or other members of the Leadership team before being initiated.
 
Level of Supervision Received and Quality Review:
   
 Under limited supervision, the employee has personal accountability for carrying out an assigned function, program, or project within the scope of established guidelines and objectives and is expected to resolve problems that arise in the normal course of the work. Completed work is generally reviewed for soundness of judgment, conclusion, adequacy, and conformance to policy.

Interpersonal Communications and Purpose:
   
 Cultivates, fosters, and maintains positive working relationships with managers, supervisors, employees, and other stakeholders to gain their cooperation and support in assigned projects/studies. Communication with all levels of the organization will involve the resolution of problems, and some degree of discretion and judgment are required in carrying out a major program and/or function of the organization.

• A seniority system that rewards employees based on length of employment.
• A merit system that rewards employees for exceptional job performance.
• Education, training, or experience to the extent that they are reasonably related to the work in question.
• Another factor related to job performance or business operations, such as paying a shift differential to workers on less popular shifts
• Travel, if the travel is a regular and necessary condition of the work performed