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)
MUSCOGEE (CREEK) NATION Seeking a POLICY ANALYST Description: Under the direction of the Human Resources Director, the Policy Analyst is responsible to review, analyze, update and write human resources policies and procedures. Principal Duties and Responsibilities: Review Human Resources Policy and Procedures manual on an as-needed basis (annually at a minimum); update as appropriate. Research and write policies; conduct extensive research that informs the development of human resources policies. Establish, implement, and maintain effective methods and processes relating to the communication of MCN policy issues; provide guidance and assistance to employees, as appropriate, in the understanding and interpretation of MCN policies; communicate policies and procedures to all staff through a range of communication channels, including briefs, reports, and presentations. Collaborate and seek input from policy stakeholders to obtain feedback on how policies affect others; ensure benefits, concerns, or consequences of policies are taken into account prior to implementation. Collaborate with Labor Relations Specialist on creating new policies/procedures. Collaborate with Training Specialist on communicating pertinent policies and procedures to new hires during orientation (on-boarding). Provide on-going customer service and response to inquiries regarding MCN Policies and Procedures. Identify emerging trends; monitor and analyze policy trends that may impact MCN; communicate information to Human Resources Director. Maintain knowledge of legal regulations and requirements related to human resources; ensures policies, procedures, and reporting are in Analyze and interpret data to create reports on a weekly/quarterly/as needed basis in areas of responsibility; provide reports that are evidence-based, well-structured, and effective at communicating policy rationale. Reports include research findings, policy recommendations, and outlining strategies. Maintain records and ensure human resources shared drive is maintained updated. Performs other duties as assigned. Minimum Requirements: Education: Bachelor's degree in Human Resources, Business Administration or related field; experience and/or other training/certification may be substituted for education. Experience: Three years related human resources administration experience to include at least one year in policy creation and analysis. Special skills: Knowledge of principles and methods for policy analysis, creation, implementation, and assessment. Excellent interpersonal and observation skills; ability to collaborate with multidisciplinary teams and departments to contribute to policy development and implementation. Excellent verbal and written communication skills. Excellent presentation skills in a one-on-one or group environment. Excellent time management skills with a proven ability to meet Ability to act with integrity, professionalism, and confidentiality. Strong analytical and problem-solving skills. Proficient with Microsoft Office Suite or related software. Preferred Requirements: Education: Master's degree in Business Administration or related field. Experience: Five years human resources administration experience. Special skills: Experience working in a diverse multi-cultural organization. Knowledge of the Muscogee (Creek) Nation. Certifications and licenses: SHRM-CP, SHRM-SCP, or THRP. Preference: Muscogee and Indian reference. Visit our website for more information@ www.muscogeenation.com Muscogee (Creek) and Indian Preferencerecblid edh7xh5hafkl79x0rt15vw1rbgh9rl
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The Muscogee Nation
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