Medical Policy Specialist jobs in Binghamton, NY

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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Grants Specialist
  • Cayuga Medical Center
  • Ithaca, NY FULL_TIME
  • Company Overview:

    Cayuga Health is the region's leading healthcare system, and most trusted driver of integrated health services, together with valued partners. We empower our people and employ our capabilities to equitably improve the well-being of the communities we serve. At Cayuga Health System, our commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies, and research protocols. We have a commitment to its employees by providing competitive rates and compensation, a comprehensive employee benefits programs, attractive working conditions, and the chance to build and explore a career opportunity by offering professional development.

    Nestled in the beautiful Finger Lakes region, Cayuga Health provides an outstanding place to work in a vibrant community. Come discover all that Ithaca, New York and Cayuga Health has to offer!

    Position overview: The Grants Specialist supports a specific portfolio of grants and contracts, seeing each grant through both pre-award and post-award activities to close out. These grants and contracts aim to advance population health goals and improve the quality of care provided by Cayuga Health System to achieve these goals. This position is an integral member of interprofessional grant-writing teams at Cayuga Health and serves as a liaison between Cayuga Health's Grants Team and partnering writers, project staff, the finance team, and funders. Therefore, this role requires commitment to both cross-functional collaboration within the organization and cross-sector collaboration with a range of community and academic partners. The ideal candidate will have strong critical thinking skills, attention to detail, project management and communication skills, financial and budgeting experience, and knowledge of grant and reporting practices.

    What you'll do:

    • Job Responsibilities include:

      General:

      • Work closely with other Grants Specialists, Community & Academic Partnership Manager, and others involved in grants for Cayuga Health to manage a portfolio of system-wide grants
      • Support the development of organizational processes and tools for grants management and capacity-building
      • Apply awareness of cultural values and practices throughout the grant process.
      • Other appropriate responsibilities not noted above

      Pre-Award:

      • Write proposal narratives which communicate key program details by working closely with the relevant content and context experts
      • Inform the development of grant proposal budgets, budget justifications, pro-formas, and resource management plans
      • Research, identify and review public and private grant opportunities and funding sources for feasibility and other internally-identified criteria

      Post-Award:

      • Support project teams and the Grants Accountant with the submission of reports and requested documentation, including tracking deadlines, vouchers, and responding to funder questions.
      • Monitor spending against grants to ensure annual targets are met
      • Ensure compliance with granting organization's regulations and requirements, including reporting protocols, reporting templates, and policies and procedures


    Minimum Qualifications:

    • Education: Bachelor's degree in a public health, healthcare administration, nonprofit administration, or related field. Master's degree in a related field (such as healthcare administration or public health) preferred.
    • Experience: At least 2 years of experience in nonprofit administration, grant writing or grants management, preferably in a medical or community health setting. This can include graduate level experience working with community partners on grant proposals or grant-funded initiatives.
    • Knowledge/Skills/Interests: Robust knowledge of, or interest in, the grant application process, public funding sources, and the private philanthropic community. Strong critical thinking skills and ability to convey complex information in a clear manner to a diverse audience. Ability to work independently, be part of cross-functional teams, and be self-motivated to set priorities and manage multiple priorities under minimal supervision. Ability to work under pressure and respond to deadlines without sacrificing quality. Demonstrated interest in the mission, vision and values of Cayuga Health System.
    • Location: This position can be 90% remote, with an estimated 10% of time necessary for in-person meetings.
    • Licensure: N/A. Certified Grants Management Specialist credentials a plus.
    • Physical Requirements: 90% sitting; 10% standing

    At this time Cayuga Health System will not sponsor a new applicant for employment authorization for this position.

    If you are interested in applying for this position and you require an accommodation, please contact Cayuga Health System at hr@cayugamed.org

    Cayuga Health System Commitment to Diversity, Equity & Inclusion

    Cayuga Health System commits to treating all people with dignity so that everyone who comes to us is safe, cared for, and respected. We will support the growth of our employees and the health of our community by embracing the rich diversity of social and cultural identities, needs, and life circumstances of all people. We strive to recognize and overcome personal biases and systemic policies that marginalize others and contribute to disparities in healthcare access, equitable care, and good health outcomes.

    Cayuga Health is dedicated to our vision for diversity, equity, and inclusion. As we strive towards our vision, we welcome the opportunity to work alongside a diverse range of employees.

  • 25 Days Ago

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Medical Billing Specialist
  • Alcohol and Drug Council of Tompkins County, Inc.
  • Ithaca, NY FULL_TIME
  • PCN: 1041 Classification: Full Time; Hourly Non-Exempt; 12-month Department: Administration Reports to: Director of Operations QUALIFICATIONS: Minimum of high school diploma or equivalency with emphas...
  • 20 Days Ago

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Bio Medical Specialist
  • UHS Hospitals
  • Johnson, NY FULL_TIME
  • Bio Medical Specialist, UHS Wilson Medical Center United Health Services is seeking a Bio Medical Specialist to join our Biomedical Engineering department at UHS Wilson Medical Center in Johnson City,...
  • 14 Days Ago

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Medical Specialist 2
  • OPWDD - Office for People with Developmental Disabilities
  • Binghamton, NY FULL_TIME
  • PRIMARY DUTIES AND RESPONSIBILITIES: In a clinical setting, the incumbent will provide diagnostic and therapeutic medical care and services under the direct supervision of a licensed physician. As the...
  • 28 Days Ago

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Endoscopy Technical Specialist
  • Cayuga Medical Center
  • Ithaca, NY FULL_TIME
  • Job Title: Endoscopy Technical Specialist Department: Endoscopy Reports To: Director of Endoscopy Job Summary: The Endoscopy Technical Specialist is responsible for the preparation of instruments, set...
  • 20 Days Ago

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CHS Appeals Specialist
  • Cayuga Medical Center
  • Ithaca, NY FULL_TIME
  • Job Title: CHS Appeals Specialist Department: Revenue Cycle Reports To: CHS Director, Denials Job Summary: The CHS Appeals Specialist works as an integral part of the Revenue Cycle team. Responsible f...
  • 22 Days Ago

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0 Medical Policy Specialist jobs found in Binghamton, NY area

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Patient Service Specialist-Orthopedics-Full Time
  • Guthrie
  • Binghamton, NY
  • Position Summary: The Patient Service Specialist provides direct, daily operational front office support. The Patient Se...
  • 4/26/2024 12:00:00 AM

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Technical Project Manager (TPM)/ Project Engineer (PE) -Software Systems Development (Onsite)
  • Raytheon Technologies
  • Binghamton, NY
  • Date Posted: 2024-04-15 Country: United States of America Location: HNY31: Binghamton, NY 31 Lewis Rd , Binghamton, NY, ...
  • 4/25/2024 12:00:00 AM

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Energy Advisor II
  • Franklin Energy
  • Binghamton, NY
  • COMPANY Summary As a combined organization, Franklin Energy and AM Conservation Group is undertaking what is perhaps the...
  • 4/25/2024 12:00:00 AM

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Patient Service Specialist - Family Medicine - Full Time
  • Guthrie
  • Binghamton, NY
  • Patient Service Specialist - Family Medicine - Full Time - Day Position Summary: The Patient Service Specialist provides...
  • 4/24/2024 12:00:00 AM

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Patient Service Specialist- Urology-Full Time
  • Guthrie
  • Binghamton, NY
  • Position Summary: The Patient Service Specialist provides direct, daily operational front office support. The Patient Se...
  • 4/24/2024 12:00:00 AM

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Travel Nurse RN - ED - Emergency Department - $2,525 per week
  • PRN Healthcare
  • Binghamton, NY
  • ARMStaffing is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Binghamton, New York. Job...
  • 4/23/2024 12:00:00 AM

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Fresh Merchandise Operations Specialist
  • Acosta Group
  • Binghamton, NY
  • **Fresh Merchandise Operations Specialist** **General Information** **Company:** ACO-US **Location:** BINGHAMTON, New Yo...
  • 4/22/2024 12:00:00 AM

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Retail Shift Leader
  • Love
  • Binghamton, NY
  • ** Retail Shift Leader** Location: Binghamton, NY, US, 13904 **Req ID:** 296010 Address: 2 Industrial Park Dr. Binghamto...
  • 4/22/2024 12:00:00 AM

Binghamton /ˈbɪŋəmtən/ is a city in, and the county seat of, Broome County, New York, United States. It lies in the state's Southern Tier region near the Pennsylvania border, in a bowl-shaped valley at the confluence of the Susquehanna and Chenango Rivers. Binghamton is the principal city and cultural center of the Binghamton metropolitan area (also known as Greater Binghamton, or historically the Triple Cities), home to a quarter million people. The population of the city itself, according to the 2010 census, is 47,376. From the days of the railroad, Binghamton was a transportation crossroads...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$86,225 to $105,252
Binghamton, New York area prices
were up 1.5% 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