Medical Policy Specialist jobs in Anaheim, CA

Medical Policy Specialist researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Being a Medical Policy Specialist establishes the proper codes to use for claims processing. Responds to questions from medical staff and communicates details about policy and guidelines. Additionally, Medical Policy Specialist requires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. The Medical Policy Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Medical Policy Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Regulatory Policy Specialist [HYBRID]
  • Southern California Edison
  • Westminster, CA FULL_TIME
  • Job Description

    Join the Clean Energy Revolution

    Become a Regulatory Policy Specialist at Southern California Edison (SCE) and build a better tomorrow. In this job, you'll help develop and execute SCE's regulatory broader policy strategy to build the foundation for a safe, green, high electrification future. You’ll support teams that lead the General Rate Case (GRC), which provides $8 billion in funds to the company; the Wildfire Mitigation Plan (WMP), which details the efforts SCE undertakes to prevent wildfires in its territory; and the licensing of large infrastructure projects. In this role, you will have the opportunity to learn various skills and the issues important to the company, which will help propel your future career at SCE.

    As a Regulatory Policy Specialist your work will help power our planet, reduce carbon emissions and create cleaner air for everyone. Are you ready to take on the challenge to help us build the future?

    A day in the life - Get ready to think big, work smart and shine bright!

    • Support the development of compelling, accurate testimony and workpapers for the GRC, WMP, and licensing applications.

    • Project manage regulatory proceedings under the jurisdiction of the California Public Utilities Commission (CPUC) and Office of Energy Infrastructure Safety.

    • Research and analyze financial and operational data sets, draw conclusions and make preliminary recommendations for use by SCE in various regulatory proceedings as needed.

    • Provide coordination across SCE to help ensure consistency of company positions and identify cross organizational issues.

    • Assist in regulatory reporting and data discovery from agencies and third parties.

    The essentials

    • Three (3) or more years of experience in consulting, utility, government, audits, or other industry requiring project or task management, written work products, and strategic thinking.
    • Excellent verbal and written communication skills.

    The preferred

    • Bachelor’s Degree in Business, Economics, Public Policy, or related field of study.
    • Experienced project manager; comfortable managing scope, schedule and deliverables in a timely and effective manner.
    • Experience with regulatory activities, including development and litigation of cost recovery applications before the CPUC.
    • Experience with writing in a business, regulatory, or policy context.
    • Experience reading and interpreting guidance from state regulatory agencies.

    You should know …

    • This position’s work mode is hybrid. The employee will report to an SCE facility for a set number of days with the option to work remotely on the remaining days. Unless otherwise noted, employees are required to reside in the state of California. Further details of this work mode will be discussed at the interview stage. The work mode can be changed based on business needs.
    • Visit our Candidate Resource page to get meaningful information related to benefits, perks, resources, testing information, and hiring process, and more!
    • Relocation is not available for this position.

    About SCEThe people at SCE don't just keep the lights on. Our mission is so much bigger. We’re fueling the kind of innovation that’s changing an entire industry, and quite possibly the planet. Join us and create a future with cleaner energy, while providing our customers with the safety and reliability they demand. At SCE, you’ll have a chance to grow personally and professionally, making a real impact in Southern California and around the world.

    At SCE, we celebrate our differences. We are a proud Equal Opportunity Employer and will not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected status.

    We are committed to ensuring that individuals with disabilities are provided reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Please contact us to request accommodations at (833) 343-0727.

  • 28 Days Ago

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Family Nurse Practitioner (Min 2 years experience)
  • Huntington Specialist Med Grp
  • Chino, CA CONTRACTOR,FULL_TIME,PART_TIME
  • Join our growing Hospitalist team!! The Hospitalist position available is located in both Chino Hills, CA & The City of Alhambra in Los Angeles County. Both Primary Care and Acute Care experience are ...
  • 12 Days Ago

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Medical Staff Service Specialist 3 - Medical Staff Admin - F/T Days
  • UC Irvine Medical Center
  • Anaheim, CA FULL_TIME
  • Medical Staff Service Specialist 3 - Medical Staff Admin - F/T Days - 63144-1A Updated: Feb 29, 2024 Location: Anaheim Job Type: Department: Medical Staff Admin UC Title: MED STF SVC SPEC 3 Position N...
  • 19 Days Ago

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Shop helper at Cylinder Head Shop
  • Quality Cylinder Head Specialist Inc.
  • Stanton, CA FULL_TIME
  • We are an automotive machine shop that rebuilds cylinder heads. We are looking for someone who can start full time and will stay with us for a long time. We are looking for someone we can train to bec...
  • 15 Days Ago

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Authorization Specialist
  • KPC GLOBAL MEDICAL CENTERS INC.
  • Santa Ana, CA FULL_TIME
  • Santa Ana, CARESPONSIBILITIES AND DUTIES:· Ensure timely verification and validation of authorizations for all Commercial and Managed care inpatients and other services as assigned.· Contacts insuranc...
  • 7 Days Ago

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Authorization Specialist
  • KPC Global Medical Centers Inc
  • Santa Ana, CA FULL_TIME
  • Santa Ana, CARESPONSIBILITIES AND DUTIES:· Ensure timely verification and validation of authorizations for all Commercial and Managed care inpatients and other services as assigned.· Contacts insuranc...
  • 1 Month Ago

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0 Medical Policy Specialist jobs found in Anaheim, CA area

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Medical Assistant Back Office
  • OC UROLOGY
  • Santa Ana, CA
  • Job Description Job Description Responsibilities Our Medical Assistants greet our patients, obtain their medical histori...
  • 4/23/2024 12:00:00 AM

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Medical Malpractice Attorney
  • Ascendion
  • Glendale, CA
  • Looking for a Medical Malpractice Attorney, who will be responsible for managing all aspects of legal proceedings for cl...
  • 4/23/2024 12:00:00 AM

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Claims Examiner –Remote
  • Generis Tek Inc
  • Irvine, CA
  • Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
  • 4/23/2024 12:00:00 AM

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Bilingual Medical Assistant - Full Time (Burbank)
  • Concentra Career Choice
  • Burbank, CA
  • Overview: Please be advised, if you are viewing this position on Indeed, that the salary rate/range set forth herein was...
  • 4/23/2024 12:00:00 AM

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Medical Malpractice Attorney
  • Ascendion
  • Glendale, CA
  • Looking for a Medical Malpractice Attorney, who will be responsible for managing all aspects of legal proceedings for cl...
  • 4/22/2024 12:00:00 AM

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Family Practice Physician Needed in Southern Orange County
  • Provider Healthcare
  • Orange County, CA
  • Job Description Job Description Job Type – Full Time Schedule - Days Pay – From $240,000 - $260,000 annually plus incent...
  • 4/21/2024 12:00:00 AM

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Mobile Phlebotomist - PRN (as needed) - Irvine, CA
  • Getlabs
  • Irvine, CA
  • Getlabs is the nationwide leader for at-home diagnostics. Healthcare organizations use our all-in-one technology platfor...
  • 4/21/2024 12:00:00 AM

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Claims Examiner -Remote
  • Generis Tek Inc
  • Irvine, CA
  • Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
  • 4/20/2024 12:00:00 AM

Anaheim (/ˈænəhaɪm/) is a city in Orange County, California, part of the Los Angeles metropolitan area. As of the 2010 United States Census, the city had a population of 336,265, making it the most populous city in Orange County and the 10th-most populous city in California. Anaheim is the second-largest city in Orange County in terms of land area, and is known for being the home of the Disneyland Resort, the Anaheim Convention Center, and two major sports teams: the Anaheim Ducks ice hockey club and the Los Angeles Angels baseball team. Anaheim was founded by fifty German families in 1857 and...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$99,194 to $121,083
Anaheim, California area prices
were up 3.2% from a year ago

Medical Policy Specialist in Norfolk, VA
Guideline 9 – specialist medical procedures provides that applications for the separate representation of children with an intellectual impairment in relation to applications for special medical procedures are not subject to the means test or merits test.
February 20, 2020