Medical Policy Specialist jobs in San Jose, 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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Policy Documentation Specialist
  • Stanford Federal Credit Union
  • Palo Alto, CA TEMPORARY
  • Policy Documentation Specialist (Temporary, 12 Months) Opportunity at Stanford Federal Credit Union!


     
    We’re on a mission to improve financial lives! If you’re a high-energy, compassionate, and collaborative individual yearning to make a difference, we are looking for individuals like you to join our team! Members really do come first at Stanford FCU because we are not-for-profit and owned by our members. Many of our members work for Stanford University or some of the most innovative companies in Silicon Valley—and we provide them with the most generous financial benefits in our industry. 

    Stanford FCU is a $4 billion company with a global reach—86,000 members in 90 countries and growing! Contact us to see what it’s like to work for one of the Bay Area’s Top Workplaces. As our CEO says, “we work hard, and we play hard”, and we need your help to improve even more financial lives!

    Who you are: 

    • 2 years of experience in policy and procedure writing. Financial Services industry experience preferred.
    • Strong financial services and regulatory compliance background.
    • High energy individual with ability to interact with various levels throughout the Credit Union.
    • Interpersonal skills to represent the Credit Union in a positive way, both internally and externally at all times.
    • Accuracy and attention to detail.
    • Demonstrated proficiency in both oral and written communications.
    • Fluency in policy language construct; ability to craft clear, concise verbiage.
    • Proficiency in facilitating cooperation among stakeholders and engage subject matter experts to drive objectives collaboratively.
    • Proficient in Microsoft Applications.
    • Strong problem solving skills and the ability to develop conceptual alternatives.
    • FISERV DNA experience preferred or experience working with multiple core systems.

    What you’ll DO:

    This position is responsible for creating and maintaining standard operations policy and procedure documents for the Credit Union teams in accordance with credit union objectives and regulatory compliance. Manage and implement communication of policies and procedures. Ensure internal chat bot and intranet are updated with most recent information. Proactively identify missing or lack of policies and procedures and collaborate throughout the Credit Union with policy owners to create necessary documents.  

    The following are major duties and responsibilities of this role:

    • Develop, publish, and maintain policies and procedures; working closely with subject matter experts to define. 
    • Working with leadership and training to proactively identify areas of operations that require policies and procedures.
    • Serve as the primary administrator for the internal chat bot to ensure staff can easily search and reference policy and procedure documents. 
    • Review internal chat bot data to identify if a policy or procedure is necessary to ensure the frontline can answer member questions and provide a good member experience. 
    • Serve as the main point of contact for incoming questions and requests.
    • Coordinate with compliance team members to ensure all documents follow regulatory compliance.
    • Partner with Training and Development Department as necessary to assist with defining policies and procedures when creating training materials and reference guides. 
    • Support change management practices related to the operations policy and procedure programs.
    • Consolidate and evolve internal communications on procedure or operational updates.
    • Demonstrated ability to translate high level conceptual information and ideas through to execution in a manner that is thorough and thoughtful to the intended audience.
    • Responsible for the coordination of the annual review of the policies and procedures. 
    • Interact and proactively communicate with varying levels of department and operations leadership to ascertain areas of need or improvement in the program.
    • Serve as a subject matter expert on policies, procedures, and processes.

    Some of our benefits for YOU:   

    • 100% paid employee medical, dental, vision, life/AD&D and short-term disability insurance for the employee; 50% paid for dependents.
    • Quarterly incentives up to 10% of your salary (based on position)
    • Employer 401(k) matching up to 5% plus additional annual discretionary contributions
    • Up to $500 per year in health/fitness benefits 
    • Employee recognition program with cash incentives 
    • Commute benefits up to $900 per year. 
    • Paid Sick Time accrues at two weeks per year.
    • Paid Vacation Time accrues at three weeks per year.
    • Paid Federal banking holidays (approximately 10 per year)
    • Ongoing training and education, seminars, and conferences
    • Loan rate discounts on some products (vehicle, mortgage and HELOC loans)
    • Waived fees and deposit bonuses on Stanford FCU accounts
    • Flex health/transit plan availability 
    • Employee Assistance Program with free benefits like counseling, help finding legal assistance and day care resources.

     

    Stanford Federal Credit Union provides pay ranges representing its good faith estimate of what the Credit Union reasonably expects to pay for a position. The pay offered to a selected candidate will be determined based on factors such as (but not limited to) the scope and responsibilities of the position, the qualifications of the selected candidate, departmental budget availability, internal equity, geographic location, and external market pay for comparable jobs.

    If you are ready for this awesome opportunity (or know somebody who is) please contact us today! 

    Please Note: SFCU does not provide work visa sponsorship or accept visa transfers for any positions. Applicants that require work visa sponsorship or transfer will not be considered for employment. SFCU does not provide any relocation benefits for any positions.   

    Stanford Federal Credit Union is committed to equal employment opportunities, and a workplace that embraces diversity and inclusion for qualified individuals of all backgrounds.

     

  • 1 Month Ago

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Senior Power Resources Specialist (Regulatory Compliance and Policy Division) - Energy Department
  • City of San Jose
  • San Jose, CA FULL_TIME
  • San José Clean Energy, or SJCE, is San José’s local, not-for-profit electricity supplier operated by the City of San José’s Energy Department. Since 2019, our dedicated and motivated team has provided...
  • Just Posted

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Policy Training Development Specialist - Trust and Safety - San Jose
  • TikTok
  • San Jose, CA FULL_TIME
  • Responsibilities TikTok is the leading destination for short-form mobile video. Our mission is to inspire creativity and bring joy. TikTok has global offices including Los Angeles, New York, London, P...
  • 1 Month Ago

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Local Merchandising Reps & Laborers
  • Apollo Retail Specialist
  • San Jose, CA PART_TIME
  • BT Retail Solutions (BTR), a division of Apollo Retail Specialists, has served America’s most respected brands as a leading construction and fixture installation company for three decades, and we are ...
  • Just Posted

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Local Merchandising Rep/Laborer
  • Apollo Retail Specialist
  • San Jose, CA PART_TIME
  • BT Retail Solutions (BTR), a division of Apollo Retail Specialists, has served America’s most respected brands as a leading construction and fixture installation company for three decades, and we are ...
  • 8 Days Ago

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Local Merchandising Rep/Laborer (PT)
  • Apollo Retail Specialist
  • San Jose, CA PART_TIME
  • $18/hr Local Merchandising Reps & Laborers- Willing to Train!BT Retail Solutions (BTR), a division of Apollo Retail Specialists, has served America’s most respected brands as a leading construction an...
  • 9 Days Ago

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0 Medical Policy Specialist jobs found in San Jose, CA area

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REMOTE: Medical Director, Utilization Management and Medical Policy
  • Evry Health
  • San Jose, CA
  • About the Role Evry Health is hiring a tech-savvy Medical Director to lead medical policy and utilization management. As...
  • 4/24/2024 12:00:00 AM

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Physician - Primary Care (Visa sponsorship / green card / US
  • Onestop Aesthetic Travel and Wellness Center
  • Pleasanton, CA
  • Job Description Job Description Physician – Primary Care (Visa sponsorship / green card / US citizens) Location: Onestop...
  • 4/24/2024 12:00:00 AM

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Medical Specialist
  • PSG Global Solutions Careers
  • South San Francisco, CA
  • Apply now and our proprietary system will quickly have you in front of a live recruiter. The Opportunity Description We'...
  • 4/24/2024 12:00:00 AM

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Azure NetApp Files Technical Marketing Engineer
  • NetApp
  • San Jose, CA
  • About NetApp Were forward-thinking technology people with heart. We make our own rules, drive our own opportunities, and...
  • 4/24/2024 12:00:00 AM

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Claims Examiner –Remote
  • Generis Tek Inc
  • San Jose, 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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Software Engineering Manager
  • NetApp
  • San Jose, CA
  • About NetApp Were forward-thinking technology people with heart. We make our own rules, drive our own opportunities, and...
  • 4/23/2024 12:00:00 AM

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Distinguished Engineer, Software and Systems
  • NetApp
  • San Jose, CA
  • About NetApp Were forward-thinking technology people with heart. We make our own rules, drive our own opportunities, and...
  • 4/23/2024 12:00:00 AM

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

San Jose is located at 37°20′07″N 121°53′31″W / 37.335278°N 121.891944°W / 37.335278; -121.891944. According to the United States Census Bureau, the city has a total area of 180.0 sq mi (466 km2), of which 3.4 sq mi (8.8 km2) (1.91%) is water, making it the fourth-largest California city by land area (after Los Angeles, San Diego and California City). San Jose lies between the San Andreas Fault, the source of the 1989 Loma Prieta earthquake, and the Calaveras Fault. San Jose is shaken by moderate earthquakes on average one or two times a year. These quakes originate just east of the city on...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$112,253 to $137,024
San Jose, California area prices
were up 2.9% 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