Medical Policy Specialist jobs in Frankfort, KY

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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Health Policy Specialist II (FFTL)
  • Commonwealth of Kentucky
  • Frankfort, KY FULL_TIME
  • Advertisement Closes
    7/20/2023 (7:00 PM EST)
    req52254
    Health Policy Specialist II (FFTL)
    Pay Grade
    15
    Salary
    $59,079.36 - $62,033.52
    Employment Type
    EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | 37.5 HR/WK
    Hiring Agency
    Cabinet for Health & Family Services | Department for Public Health
    Location
    275 E Main St Frankfort KY 40621 USA

    The agency may authorize the selected candidate to telecommute. The agency may terminate or modify the telecommuting arrangement at any time.
    Description
    We are looking for an energetic, career-minded individual to work in the Kentucky Department for Public Health (DPH) Division of Prevention and Quality Improvement (DPQI), Chronic Disease Prevention Branch in the Colon Cancer Screening Program. This division is the cornerstone of state public health efforts to address chronic disease through prevention for the underserved population and improve the health status of Kentuckians.

    This position plays a primary role in the new five year Colon Cancer Health Systems grant from the Centers for Disease Control and Prevention (CDC) and works with the leadership team designated to develop and implement the strategies of this workplan including new models for access including telehealth and alternate approved colon cancer screening. You will be able to make an immediate impact on reducing Colon Cancer in Kentucky by working with the CDC, health systems, universities, clinics, advocacy organizations such as American Cancer Society, patient navigators and Federally Qualified Health Centers.

    The KY Department for Public Health offers competitive wages.

    This is a federally funded time limited (FFTL) position. This means it is a position that is paid entirely as the result of a federal grant. The duration of employment shall not exceed the life of the federal grant that funds the position. An employee appointed to an FFTL position is required to meet the minimum requirements for the classification. Further, an employee appointed to an FFTL position is designated as an unclassified (non- merit) employee. An FFTL employee is eligible to receive benefits at the same level as a classified (merit) employee in a permanent position.

    Responsibilities and Duties include but are not limited to:
    • Recommends policies, goals, and strategies to improve colon cancer screening rates utilizing evidence-based interventions
    • Provides complex technical assistance to the public, health care organizations such as Federally Qualified Health Centers, hospitals and managed care organizations, and professional organizations
    • Coordinates and evaluates colon cancer screening program initiatives to identify appropriate process measures and monitoring for quality and performance improvement based on health systems engineering tools and principles,
    • Organizes and presents policy options for increasing colon cancer screening to management staff within the program, branch, division and department to eliminate barriers to team success and provides guidance to sustain improvement changes.
    • Assists in the development of evaluation tools that will produce quantitative and qualitative data and findings to validate program outcomes and determine health care needs and resources.
    • Provides analysis reports and recommendations utilizing current available colon cancer screening data in health systems
    The ideal candidate will have:
    • Preferred candidate will have exceptional attention to detail and excellent communication skills
    • Proficient in Microsoft Excel, Word. PowerPoint and Outlook
    • Health policy, project management, grant writing and reporting experience.
    • Leadership skills in meeting management and partnership development.
    • Quality assurance or program evaluation background.
    The Cabinet for Health and Family Services (CHFS) participates in E-Verify and will provide the federal government with your Form I-9 information to confirm that you are authorized to work in U.S. CHFS will only use E-Verify once you have accepted a job offer and completed the Form I-9.

    For more information on E-Verify, or if you believe that CHFS has violated its E-Verify responsibilities, please contact Department of Homeland Security (DHS) at 888-897-7781 or https://dhs.gov/e-verify
    Minimum Requirements
    EDUCATION: Graduate of a college or university with a bachelor's degree.

    EXPERIENCE, TRAINING, OR SKILLS: Four years of professional experience in managed health care, Medicaid, Medicare, health insurance claims/systems, health care research, health care planning, health care policy development, health care administration, public health, or population health.

    Substitute EDUCATION for EXPERIENCE: Graduate work in planning, public health, public administration, health administration, business administration, or a related field will substitute for the required experience on a year-for-year basis up to two years.

    Substitute EXPERIENCE for EDUCATION: Professional experience in the preparation of health care reports, health care audits, or health data tables will substitute for the required education on a year-for-year basis.

    SPECIAL REQUIREMENTS (AGE, LICENSURE, REGULATION, ETC.): NONE
    Working Conditions
    Incumbents working in this job title primarily perform duties in an office setting.
    If you have questions about this advertisement, please contact Sue Thomas-Cox at Sue.Thomas-Cox@ky.gov or 502-564-7996.
    An Equal Opportunity Employer M/F/D
  • 21 Days Ago

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Health Policy Specialist II (FFTL)
  • Kentucky Department Of Corrections
  • Frankfort, KY FULL_TIME
  • Advertisement Closes 7/20/2023 (7:00 PM EST) req52254 Health Policy Specialist II (FFTL) Pay Grade 15 Salary $59,079.36 - $62,033.52 Employment Type EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIM...
  • 21 Days Ago

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Health Policy Specialist I (FFTL)
  • Commonwealth of Kentucky
  • Frankfort, KY FULL_TIME
  • Advertisement Closes 4/14/2023 (8:00 PM EDT) 23-03091 Health Policy Specialist I (FFTL) Pay Grade 13 Salary $48,828.00 Employment Type EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | ...
  • 1 Month Ago

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Health Policy Specialist I (FFTL)
  • Kentucky Department Of Corrections
  • Frankfort, KY FULL_TIME
  • Advertisement Closes 4/14/2023 (8:00 PM EDT) 23-03091 Health Policy Specialist I (FFTL) Pay Grade 13 Salary $48,828.00 Employment Type EXECUTIVE BRANCH | FULL TIME | ELIGIBLE FOR OVERTIME PAY | 18A | ...
  • 1 Month Ago

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Medical Records Specialist
  • Frankfort Regional Medical Center
  • Frankfort, KY FULL_TIME
  • Introduction Do you want to join an organization that invests in you as a(an) Medical Records Specialist? At Frankfort Regional Medical Center, you come first. HCA Healthcare has committed up to $300 ...
  • 14 Days Ago

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Medical Office Specialist
  • Capital Surgical Clinic
  • Frankfort, KY FULL_TIME
  • Introduction Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an...
  • 30 Days Ago

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0 Medical Policy Specialist jobs found in Frankfort, KY area

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CDL-A OTR Truck Driver - Earn 45-60 CPM + Benefits
  • U.S. Xpress
  • Frankfort, KY
  • U.S. Xpress is Now Hiring CDL-A OTR Solo Drivers! Top Benefits: Average 2,220+ miles per week Earn 45-60 CPM based on lo...
  • 4/24/2024 12:00:00 AM

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CDL-A OTR Team Drivers - Top Team Pay + Great Benefits
  • U.S. Xpress
  • Frankfort, KY
  • U.S. Xpress is Now Hiring CDL-A OTR Team Drivers! CDL-A Teams: Top Team Pay in the Nation & Up To $15,000 Sign-On Bonus/...
  • 4/24/2024 12:00:00 AM

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Informatics Analyst
  • Cvs Health
  • Frankfort, KY
  • Bring your heart to CVS Health. Every one of us at CVS Health shares a single, clear purpose: Bringing our heart to ever...
  • 4/24/2024 12:00:00 AM

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Construction Cost Manager (West Region)
  • Finish Line Inc.
  • Frankfort, KY
  • Construction Cost Manager (West Region) page is loaded Construction Cost Manager (West Region) Apply locations Californi...
  • 4/24/2024 12:00:00 AM

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Senior Advisor
  • Public Consulting Group
  • Frankfort, KY
  • Public Consulting Group Senior Advisor Frankfort , Kentucky Apply Now Public Consulting Group, Inc. (PCG) is a leading p...
  • 4/24/2024 12:00:00 AM

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Medical Science Liaison - Oncology
  • Ipsen Pharma
  • Louisville, KY
  • Title: Medical Science Liaison - Oncology Company: Ipsen Biopharmaceuticals Inc. Job Description: Medical Science Liaiso...
  • 4/23/2024 12:00:00 AM

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Mobile Phlebotomist - PT - Louisville, KY
  • Getlabs
  • Louisville, KY
  • Getlabs is the nationwide leader for at-home diagnostics. Healthcare organizations use our all-in-one technology platfor...
  • 4/20/2024 12:00:00 AM

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PACE Nurse Practitioner (APRN)
  • Bluegrass Care Navigators
  • Lexington, KY
  • Job Type Full-time Description PACE Nurse Practitioner (APRN) Location: Lexington, KY Schedule: Monday-Friday 8am-4:30pm...
  • 4/20/2024 12:00:00 AM

Frankfort is the capital city of the Commonwealth of Kentucky and the seat of Franklin County. It is a home rule-class city in Kentucky; the population was 25,527 at the 2010 census. Located along the Kentucky River, Frankfort is the principal city of the Frankfort, Kentucky Micropolitan Statistical Area, which includes all of Franklin and Anderson counties. Frankfort is located in the (inner) Bluegrass region of Central Kentucky. The city is bisected by the Kentucky River, which makes an s-turn as it passes through the center of town. The river valley widens at this point, which creates fou...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$81,752 to $99,792
Frankfort, Kentucky 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