Medical Policy Manager jobs in Rock Island, IL

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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Compliance Analyst - CRIMS Policy Implementation - Hybrid
  • Living Talent Company
  • Illinois, IL FULL_TIME
  • Investment Management Firm (100B AUM) 

    • Hybrid, 3 days in office in Chicago Loop 
    • Full relocation available
    • Base Bonus 120k - 140k
    • Robust benefits package 
    Role & Responsibilities 

    • CRIMS policy implementation. 
    • Governing Document Review: Interpret investment agreements and documents to identify compliance requirements and establish validation rules.
    • Compliance Rule Creation: Develop and document new rules in Charles River IMS.
    • Portfolio Guidelines Accuracy: Ensure accuracy of client portfolio guidelines in CRIMS.
    • Restriction List Management: Maintain and update client-directed restriction lists.
    • Post-Trade Report Review: Daily review of reports for compliance alerts and necessary corrections.
    • Support for Portfolio and Trading: Provide support on compliance queries from clients and colleagues.
    • Compliance Alert Analysis: Analyze alerts for accurate decisions, utilizing expertise and data.
    • Automation Improvement: Assist in enhancing automation capabilities.
    • Supervisory Exception Report Review: Review and address potential exceptions identified in daily reports.
    • Client Account Certifications: Complete periodic certifications and questionnaires.
    • Forensic Testing: Conduct testing to ensure adherence to trading policies and identify irregularities.
    • Policy and Procedure Updates: Assist in updating compliance policies in response to business or regulatory changes.
    • Process Efficiency Initiatives: Identify and implement process improvements.
    • Participation in Initiatives: Engage in compliance-related initiatives and projects as assigned.  

    Experience & Skills 

    Charles River IMS
    • 3 years coding client and regulatory guidelines in CRIMS
    • including: complex (conditional) compliance rules & benchmark comparative rules.
    5 years of Compliance within Investment Management.
    • ideally: US fund compliance, SMAs, Portfolio Administration, Operations, or Risk Management.
    • Compliance rule construction and data requirements.
    • Sound knowledge of: equity, fixed income & derivative asset classes.
    • Proven experience working with the front office.
    • Familiarity with trade order lifecycle.
    • Understanding of: Securities industry and regulatory requirements (IAA, ICA, ERISA)
    • Data Analysis and proficiency with SQL, v-lookup, pivot tables, etc., MS SQL Server, Excel
    • Interpersonal skills, ability to work independently and in teams.
    • Bachelor's degree
    Required: Availability for remote after-hours support to resolve compliance alerts during nightly system updates. Email and/or phone accessibility during non-business hours.

    Preferred: Knowledge with other rules and regulations (FINRA, CFTC, Securities Act of 1933, Securities Exchange Act of 1934) . Familiarity ESG and global regulatory requirements.
  • 25 Days Ago

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Medical Director
  • Theoria Medical
  • Muscatine, IA FULL_TIME
  • *****APPLY TODAY***** Company Overview Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute ca...
  • 1 Month Ago

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Medical Director
  • Theoria Medical
  • Donnellson, IA FULL_TIME
  • *****APPLY TODAY***** Company Overview Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute ca...
  • 1 Month Ago

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Medical Director/Attending Physician
  • Theoria Medical
  • Muscatine, IA PART_TIME,FULL_TIME
  • *****APPLY TODAY***** Company Overview Theoria Medical is a comprehensive medical group and technology company dedicated to serving patients across the care continuum with an emphasis on post-acute ca...
  • 23 Days Ago

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Travel Registered Nurse RN Medical Surgical
  • OneStaff Medical
  • Rock Island, IL OTHER
  • We. Are. OneStaff. Medical. An independently - owned, nationally - recognized and amazingly awesome staffing firm ready to work for you! A work ethic forged in the Midwest, we are here to stand by you...
  • 29 Days Ago

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Medical Courier Job
  • Medical Courier Job Jobs Hiring
  • Argyle, IA FULL_TIME
  • (Hiring Immediately) Part/Full-Time Medical Courier Job Jobs Available in Argyle, IA. No Experience Required.
  • 24 Days Ago

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0 Medical Policy Manager jobs found in Rock Island, IL area

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Registered Nurse
  • Innovative Systems Group
  • Rock Island, IL
  • Job Description Job Description JOB PURPOSE: This position is responsible for conducting medical management and health e...
  • 4/23/2024 12:00:00 AM

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Remote Licensed Mental Health Counselor
  • Hiring Now!
  • Davenport, IA
  • Remote Licensed Mental Health Counselor (LMHC) Wage: Between $90-$122 an hour Are you a Licensed Mental Health Counselor...
  • 4/22/2024 12:00:00 AM

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Remote Licensed Marriage and Family Therapist
  • Hiring Now!
  • Davenport, IA
  • Remote Licensed Marriage and Family Therapist (LMFT) Wage: Between $90-$122 an hour Are you a Licensed Marriage and Fami...
  • 4/22/2024 12:00:00 AM

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Remote Licensed Clinical Social Worker
  • Hiring Now!
  • Davenport, IA
  • Remote Licensed Clinical Social Worker (LCSW) Wage: Between $90-$122 an hour Are you a Licensed Clinical Social Worker l...
  • 4/22/2024 12:00:00 AM

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Remote Licensed Professional Counselor
  • Hiring Now!
  • Davenport, IA
  • Remote Licensed Professional Counselor (LPC) Wage: Between $90-$122 an hour Are you a Licensed Professional Counselor lo...
  • 4/22/2024 12:00:00 AM

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Remote Licensed Clinical Psychologist
  • Hiring Now!
  • Davenport, IA
  • Remote Licensed Clinical Psychologist Wage: Between $90-$174 an hour Are you a Licensed Clinical Psychologist looking to...
  • 4/22/2024 12:00:00 AM

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Direct Support Staff - Crisis Residential Services
  • Vera French Community Mental Health Center
  • Davenport, IA
  • JOIN OUR TEAM! Are you looking to make a difference in someone's life by promoting physical and emotional health? Are yo...
  • 4/21/2024 12:00:00 AM

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Direct Support Staff - HAB Program
  • Vera French Community Mental Health Center
  • Davenport, IA
  • JOIN OUR TEAM Are you looking to make a difference in someone's life by promoting physical and emotional health? Are you...
  • 4/21/2024 12:00:00 AM

Rock Island is a city in and the county seat of Rock Island County, Illinois, United States. The original Rock Island, from which the city name is derived, is the largest island on the Mississippi River. It is now called Arsenal Island. The population was 39,018 at the 2010 census. Located on the Mississippi River, it is one of the Quad Cities, along with neighboring Moline, East Moline, and the Iowa cities of Davenport and Bettendorf. The Quad Cities has a population of about 380,000. The city is home to Rock Island Arsenal, the largest government-owned weapons manufacturing arsenal in the U...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$122,602 to $149,672
Rock Island, Illinois area prices
were up 1.3% from a year ago

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