Medical Policy Manager jobs in Des Moines, IA

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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Policy Conversion Consultant Manager
  • EMC Insurance Companies
  • Des Moines, IA FULL_TIME
  • At EMC, you'll put your skills to good use as an important member of our team. You can count on gaining valuable experience while contributing to the company's success. EMC strives to hire and retain the best people by engaging, developing and rewarding employees.

    Serves as policy conversion subject matter expert. Guides external contractors through complex work issues and answers questions and serves as point of escalation for highly complex issues. Evaluates issues and provides resolution impacting the conversion process. If needed, escalates to IT, data conversion, policy administration teams for resolution and monitors status of resolution and impact to pending work. Oversees a team of independent contractors, providing guidance and status monitoring. Evaluates current processes and modifies approaches or makes recommendations to leadership for changes. Serves as the Underwriting conversion project leader.

    Essential Functions:

    • Point of escalation to answer complex questions requiring expert knowledge of commercial products (ISO, NCCI, state rules), Guidewire/Policy Center, business process and business requirements
    • Proactively participates and drives conversion mapping strategy with the project team and promotes decisions that will improve the conversion process for the conversion team, underwriting and rating
    • Serves as the commercial policy conversion expert leading the team to efficiently transfer policies to new policy administration systems
    • Responsible for monitoring service levels and quality metrics of the team; provides feedback to improve performance
    • Builds and maintains relationships with underwriting and rating departments and partners to identify and implement process improvements to reduce expense and the time necessary to convert policies
    • Manages vendor relationships, feedback, quality, and assists with contract negotiations

    Education & Experience:

    • Bachelor's degree in business administration, computer science, or related field, or equivalent relevant experience
    • Eight years of experience in underwriting, business analysis, or technical project management or related experience
    • Prior experience with project management preferred
    • Experience with workforce management principles and tools preferred
    • Previous leadership experience preferred

    Knowledge, Skills & Abilities:

    • Guidewire experience or certification desired
    • Excellent ability to lead, motivate, and develop team members
    • Strong ability to lead others through change
    • Excellent knowledge of commercial lines products and business processes
    • Strong interpersonal skills and conflict resolution abilities
    • Excellent analytical, problem-solving, organizational, and prioritization skills
    • Strong ability to transfer data into meaningful business insights
    • Proven continuous improvement skills
    • Strong business process management skills
    • Strong written and verbal communication skills

    Per the Colorado Equal Pay for Equal Work Act, the hiring range for this position for Colorado-based team members is $102,000 - $131,000. The hiring range for other locations may vary.

    Our employment practices are in accordance with the laws that prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

    All of our locations are tobacco free including in company vehicles.

    To learn more about why you're gonna love it here, watch the video below.


    Our employment practices are in accord with the laws which prohibit discrimination due to race, color, creed, sex, sexual orientation, gender identity, genetic information, religion, age, national origin or ancestry, physical or mental disability, medical condition, veteran status, active military status, citizenship status, marital status or any other consideration made unlawful by federal, state, or local laws.

     

  • 13 Days Ago

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Veterinary Medical Officer (Veterinary Biologics Science and Policy Advisor)
  • US Animal and Plant Health Inspection Service
  • Ames, IA FULL_TIME
  • Duties The duties may include, but are not limited to: Provides scientific and technical guidance in the management of formulating, organizing, and executing veterinary biologics regulations and polic...
  • 3 Days Ago

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Program Analyst
  • US Office of Field Policy and Management
  • Des Moines, IA FULL_TIME
  • Duties The following are the duties of this position at the GS-13. If you are selected at a lower grade level, you will have the opportunity to learn to perform all these duties, and will receive trai...
  • 1 Month Ago

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Policy and procedure
  • Innova Solutions
  • Des Moines, IA FULL_TIME
  • Innova Solutions is hiring for a Business Execution Consultant : Policy and Procedure review Position type : Business Execution Consultant : Policy and Procedure review Duration : 12 Months Location :...
  • 18 Days Ago

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Director Accounting Policy
  • Security Benefit Business Services / Everly Life
  • Des Moines, IA FULL_TIME
  • Security Benefit is searching for an experienced Director, Accounting Policy, with proven experience to join our Finance team. This position will work in our Des Moines, Iowa, Overland Park or Topeka,...
  • 24 Days Ago

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Senior Policy Research Analyst
  • Mom's Meals
  • Ankeny, IA FULL_TIME
  • The Senior Policy Research Analyst will perform policy research and data analysis related to healthcare spending and successful aging while supporting the overall activities of Mom’s Meals Government ...
  • 3 Days Ago

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0 Medical Policy Manager jobs found in Des Moines, IA area

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Remote Licensed Mental Health Counselor
  • Headway
  • Des Moines, IA
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $120-$131 an hour Are you a Licensed Mental Health Counselo...
  • 3/28/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Headway
  • Des Moines, IA
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $120-$131 an hour Are you a Licensed Clinical Social Worker ...
  • 3/28/2024 12:00:00 AM

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Intake Licensed Mental Health Therapist-Independent - EB
  • UnityPoint Health
  • Des Moines, IA
  • To work directly with clients of the Assertive Community Treatment Team (ACT) by using the evidence base practice model ...
  • 3/28/2024 12:00:00 AM

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Substance Use Disorder Counselor - CADC - Eyerly Ball
  • UnityPoint Health
  • Des Moines, IA
  • Overview: To work directly with clients of the Assertive Community Treatment Team (ACT) by using the evidence base pract...
  • 3/28/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Headway
  • Des Moines, IA
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $120-$131 an hour Are you a Licensed Marriage and Fam...
  • 3/28/2024 12:00:00 AM

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Remote Licensed Professional Counselor
  • Headway
  • Des Moines, IA
  • Remote Licensed Professional Counselor (LPC) Wage: Between $120-$131 an hour Are you a Licensed Professional Counselor l...
  • 3/28/2024 12:00:00 AM

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Remote Licensed Psychiatrist
  • Headway
  • Des Moines, IA
  • Remote Licensed Psychiatrist Wage: Between $232 - $269 an hour Are you a licensed Psychiatrist looking to launch a priva...
  • 3/28/2024 12:00:00 AM

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CMA PT Weekends 6-2 The Gardens Assisted Living
  • Luther Park Community
  • Des Moines, IA
  • Job Type Part-time Description We have an immediate opening for a part-time CMA 6:00 am - 2:15 pm and every other weeken...
  • 3/25/2024 12:00:00 AM

Des Moines (/dɪˈmɔɪn/ (listen)) is the capital and the most populous city in the U.S. state of Iowa. It is also the county seat of Polk County. A small part of the city extends into Warren County. It was incorporated on September 22, 1851, as Fort Des Moines, which was shortened to "Des Moines" in 1857. It is on and named after the Des Moines River, which likely was adapted from the early French name, Rivière des Moines, meaning "River of the Monks". The city's population was 217,521 as of the 2017 population estimate. The five-county metropolitan area is ranked 89th in terms of population in ...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$126,089 to $153,933
Des Moines, Iowa area prices
were up 0.8% from a year ago

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