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)
Description
Job Title: Program Policy Manager
Department: Natural Resources
Reports to: Julie Owens
FLSA Status: Exempt
TS Range: 11/12 ($36.94)
Opening Date: March 8, 2024
Closing Date: March 22, 2024
SUMMARY: Performs a variety of high-level administrative support to department director / assistant director and works primarily independently with some level of direction. Act on behalf of the department managers on significant administrative matters or delegated key program elements that would normally fall into the manager’s area of program responsibility. Supervises office staff and manages the day-to-day functions of the office services. Manages independent projects.
ESSENTIAL DUTIES AND RESPONSIBILITIES: include the following. Other duties may be assigned.
SUPERVISORY RESPONSIBILITIES: This position has supervisory responsibilities
QUALIFICATIONS: To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
OTHER
? Must maintain the utmost confidentiality in all work, cases and files pertaining to projects and activities of this position.
? Ability to articulate performance issues and fairly evaluate staff through written and verbal means.
? Must have strong managerial experience and decision-making skills.
? Ability to resolve conflict in a timely and calm manner.
? Ability to give and receive feedback.
? Ability to contribute to building positive team spirit, putting the success of the team above own interests.
? Ability to motivate, develop, and direct people in their work.
? Ability to collaborate with all departments and tribal staff to ensure a smooth functioning and cohesive unit and organization.
? Ability to be an active listener, giving full attention to what others are saying and taking time to understand the points being made.
? Ability to monitor performance of yourself and your direct reports to make improvements or take corrective actions.
LANGUAGE SKILLS: Ability to read, analyze and interpret general business periodicals, professional journals, technical procedures or government regulations written in English. Ability to write reports, business correspondence, and procedure manuals in English. Ability to communicate clearly with the Director and staff and effectively present information and respond to questions from groups of managers, clients, customers and the general public.
MATHEMATICAL SKILLS: Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
COMPUTER SKILLS: Microsoft Office Suite
REASONING ABILITY: Ability to define problems, collect data, establish facts, and draw valid conclusions. Ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
CERTIFICATES AND LICENSES: Valid Washington State Driver’s License. Insurable through the Tribe’s policy. Meet the criteria for a Class III gaming license
PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of the job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to talk or hear; occasionally required to stand; walk; sit; use hands to finger, handle or feel; and reach with hands and arms. The employee must frequently lift and/or move up to 10 pounds and occasionally lift and/or move up to 50 pounds. Specific Vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.
WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions
While performing the duties of this job, the employee is frequently exposed to tobacco smoke. The employee is occasionally exposed to outside weather conditions. The noise level in the work environment is usually loud.
DRUG FREE WORKPLACE: The successful candidate will be required to have a urinalysis for drug and alcohol screening in accordance with the tribes drug free workplace policy.
INDIAN PREFERENCE: Indian Preference will be exercised in the hiring of this position in accordance with the Tribe’s Personnel Policies.
TO APPLY: Submit application packets including a resume and cover letter to apply@squaxin.us Contact Human Resources for more information: 360-432-3865.
Requirements
EDUCATION and/or EXPERIENCE: MA and 3 years of relevant experience OR BA and 5 years of relevant experience OR AA and 7 years of relevant experience OR HS and 9 years
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