Medical Policy Specialist jobs in Charleston, WV

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)

W
Academic Officer
  • West Virginia Higher Education Policy Commission
  • Charleston, WV FULL_TIME
  • General Job Summary

    This position is responsible for ensuring compliance with academic policies and processes in the Academic Affairs division of the West Virginia Higher Education Policy Commission (Commission) and the West Virginia Council for Community and Technical College Education (Council). The role will support strengthening collaboration among and between postsecondary institutions and partners. The Commission serves as the coordinating board for the state’s public universities and the Council performs this role for public community and technical colleges. Both are statutorily charged with authorizing private and proprietary postsecondary institutions to operate in West Virginia.

    Classification: Full Time, Non-Classified, Exempt, Benefits-Eligible

    Duties and Responsibilities

    • Assists the Vice Chancellor for Academic Affairs with ensuring institutions are meeting policy and statutory requirements prescribed for postsecondary academic matters.
    • Oversee initial and annual reauthorization of postsecondary institutions to operate in West Virginia by coordinating the authorization of degree-granting institutions (both in-state and online) as outlined in Series 20.
    • Coordinates annual re-authorization processes for all institutions of higher education that confer associate degrees and higher degrees as specified in Series 52.
    • Review and make recommendations regarding the proposed delivery of new academic and technical education programs by coordinating the post-audit process for newly implemented AAS programs within the Community College System.
    • Coordinate Tuition Contract program for Veterinary Medicine, Optometry and Podiatry.
    • Coordinates institutional program review and program planning processes as outlined in Series 10. Ensure institutions complete program review requirements and monitor progress of institutions on implementing review recommendations.
    • Assists the Vice Chancellor with coordinating annual statewide academic planning processes.
    • Manage and update state postsecondary program inventory.
    • Coordinate state general education and course transfer review processes.
    • Manage the state’s Southern Region Education Board (SREB) Academic Common Market program and contract/reciprocity agreements with out-of-state institutions.
    • Coordinate statewide adult degree completion programs – Regents Bachelor of Arts and Board of Governors Associate of Applied Arts.
    • Provide general support with Academic Affairs initiatives including but not limited to dual enrollment, open educational resources, co-requisite course delivery, micro-credentialing, policy development, and tuition reciprocity agreements.
    • Provides support through preparing reports and presentations for the Commission, Council, Legislature, and other workgroups and committees as needed.
    • Develops and delivers professional presentations at local, regional, and national meetings and conferences.
    • As future circumstances or opportunities arise, assist with academic affairs programs, initiatives, policy implementation, etc. on an as needed basis.
    • Other duties as assigned.

    Minimum Requirements

    A Master’s degree is required, preferably in a field of study related to education, public administration, business, or public policy.

    A minimum of three years of relevant experience in the field of postsecondary education is required.

    The ideal candidate will have experience at a postsecondary board/system office or institution discharging planning, development, and analysis responsibilities in support postsecondary program delivery.

    REQUIRED KNOWLEDGE, SKILLS, AND ABILITIES:

    • Knowledge of postsecondary academic administration, trends, issues, and processes.
    • Familiarity with collaborative practices needed for effective development and administration of postsecondary academic policies.
    • Proven ability to balance a wide range of responsibilities.
    • Effective written and oral communication skills for audiences internal and external to the agency.
    • Ability to analyze data and synthesize complex information.
    • Committed to teamwork, public service, and the mission of postsecondary education.

    Supplemental Information

    Closing Date: April 26, 2024

    Application Process:
    In addition to filling out the job application, qualified candidates must submit a letter of interest and contact information for three professional references.

    DETAILS OF RELEVANT WORK EXPERIENCE MUST BE SHOWN IN THE DUTIES SECTION OF YOUR APPLICATION TO RECEIVE CREDIT FOR YOUR EXPERIENCE.

    Final candidates are subject to employment and credential verification, as well as reference and background checks.


    Equal Opportunity/
    Affirmative Action Employer/Veterans/Disabled
    The West Virginia Higher Education Policy Commission and the Community and Technical College System of West Virginia are equal opportunity employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, or protected veteran status and will not be discriminated against on the basis of disability. The Commission and Council provide a collegial, respectful and inclusive environment that values the diversity, creativity and contributions of its staff.

  • 17 Days Ago

W
Vice Chancellor for Finance and Facilities
  • West Virginia Higher Education Policy Commission
  • Charleston, WV FULL_TIME
  • General Job Summary Under administrative direction from the Chancellor for Higher Education and/or the Executive Vice Chancellor for Administration, performs significant complex professional and admin...
  • 28 Days Ago

W
HIM Specialist
  • Watertown Regional Medical Center
  • Beckley, WV FULL_TIME
  • Raleigh General HospitalDescription Raleigh General Hospital Who We Are: People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Raleigh Gener...
  • 19 Days Ago

W
Revenue Specialist
  • Watertown Regional Medical Center
  • Beckley, WV FULL_TIME
  • Raleigh General HospitalDescription Raleigh General Hospital Who We Are: People are our passion and purpose. Come work where you are appreciated for who you are not just what you can do. Raleigh Gener...
  • Just Posted

C
Senior Residency Program Specialist -- Medical Education -- Memorial-WVU
  • Charleston Area Medical Center (CAMC) Health System
  • Charleston, WV FULL_TIME
  • Job Summary Under limited supervision of the Program Director and the Office of Graduate Medical Education, provides professional support and management of a graduate medical education residency progr...
  • 1 Month Ago

G
Medical Billing Specialist
  • Generations Physical Therapy
  • Hurricane, WV FULL_TIME
  • Generations Physical Therapy is looking to hire for a full time Medical Billing Specialist at our Hurricane Location. Must have experience in medical billing. Job Type: Full-time Pay: $12.00 - $18.00 ...
  • 29 Days Ago

Filters

Clear All

Filter Jobs By Location
  • Filter Jobs by companies
  • More

0 Medical Policy Specialist jobs found in Charleston, WV area

C
Physician
  • Cabin Creek Health Systems
  • Belle, WV
  • Job Title: Family Practitioner Supervision Received: Chief Medical Officer Salary Range: $220,000- $270,000 (Based on ex...
  • 4/26/2024 12:00:00 AM

C
Physician
  • Cabin Creek Health Systems
  • Clendenin, WV
  • Job Title: Family Practitioner Supervision Received: Chief Medical Officer Salary Range: $220,000- $270,000 (Based on ex...
  • 4/26/2024 12:00:00 AM

C
PHYSICIAN ASSISTANT
  • Cabin Creek Health Systems, Inc.
  • Charleston, WV
  • Job Description Job Description Job Title: Physicians Assistant Position Class: Exempt Supervision Received: Chief Medic...
  • 4/26/2024 12:00:00 AM

C
PHYSICIAN
  • Cabin Creek Health Systems, Inc.
  • Charleston, WV
  • Job Description Job Description Job Title: Family Practitioner Position Class: Exempt Supervision Received: Chief Medica...
  • 4/24/2024 12:00:00 AM

H
Sr. General Accounting Manager
  • Homesafe Alliance
  • Charleston, WV
  • HomeSafe Alliance Sr. General Accounting Manager Charleston , West Virginia Apply Now HomeSafe Alliance is the single gl...
  • 4/24/2024 12:00:00 AM

A
Medical Science Liaison (OH, IN, MO or KS)
  • Atlas Search Llc.
  • Charleston, WV
  • We are currently partnered with biopharmaceutical company that is seeking a Medical Science Liaison to join their team b...
  • 4/24/2024 12:00:00 AM

C
Business Payroll Specialist
  • Cnbohio
  • Charleston, WV
  • Reports To: Operations Department ManagerAt Citizens National Bank, we have surrounded ourselves with some of the bright...
  • 4/23/2024 12:00:00 AM

F
Geotechnical Engineer
  • Firstenergy Corporation
  • Charleston, WV
  • FirstEnergy at a GlanceWe are a forward-thinking electric utility powered by a diverse team of employees committed to ma...
  • 4/23/2024 12:00:00 AM

Charleston is the most populous city in, and the capital of, the U.S. state of West Virginia. Located at the confluence of the Elk and Kanawha rivers, the population during the 2017 Census Estimate was 47,929. The Charleston metropolitan area as a whole had 214,406 residents. Charleston is the center of government, commerce, and industry for Kanawha County, of which it is the county seat. Early industries important to Charleston included salt and the first natural gas well. Later, coal became central to economic prosperity in the city and the surrounding area. Today, trade, utilities, governm...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$80,500 to $98,264
Charleston, West Virginia area prices
were up 1.2% 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