Medical Policy Specialist jobs in Santa Cruz, 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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Operations and Policy Analyst
  • University of California Santa Cruz
  • Santa Cruz, CA FULL_TIME
  • Operations and Policy Analyst


    Location:
    Santa Cruz
    Job ID: 40869

    JOB POSTING


    This position is based on campus at UCSC, with the opportunity for a hybrid on-campus / remote work schedule.

    NOTIFICATIONS

    UC Vaccination Policy: With limited exceptions, COVID-19 vaccinations are required for Covered Individuals under the Policy. Covered Individuals include all employees, students, or trainees who physically access a University facility or program in connection with their employment, appointment, or education/training.

    Covered Individuals do NOT include employees who work 100% remotely with NO expectation that they will physically access any University location or program at ANY time. If 100% remote work ends, the employee is subject to policy.

    INITIAL REVIEW DATE (IRD)

    UC Santa Cruz staff jobs are posted until filled. Application materials submitted by 11:59 pm on the IRD will be routed to the hiring unit for consideration. NOTE: Materials submitted after the IRD will be forwarded only at the request of the hiring unit. Submit your materials before the IRD to ensure consideration by the hiring unit.

    The IRD for this job is: 08-31-2022

    ABOUT UC SANTA CRUZ

    UC Santa Cruz is a public university like no other in California, combining the experience of a small, liberal arts college with the depth and rigor of a major research university. It's known as an unconventional place where innovation and experimentation is part of the campus's DNA. That playful, bold spirit still thrives today, all on a campus renowned as among the most beautiful in the world.

    DEPARTMENT OVERVIEW

    The Office of Undergraduate Admissions generates, reviews, and processes in excess of 67,000 applications and serves approximately 38,000 campus visitors each year. The office has 44 career staff FTE, 45-50 part-time/temporary staff, and 150 student staff. Staff work locally and regionally throughout California and the nation.

    The office is part of Enrollment Management, which includes Financial Aid and Scholarships, Orientation and Undergraduate Admissions. Enrollment Management is part of the multi-faceted academic Division of Undergraduate Education. Undergraduate Admissions, Enrollment Management and Undergraduate Education work closely with select Academic Senate committees.

    Since its founding in 1965, the University of California, Santa Cruz, has grown from 652 students to nearly 19,000 students (2017-18) and earned international distinction as a world university with high-impact research, ranking 3rd in the world for research influence by Times Higher Education, and among the top 50 universities in the world, according to the U.S. News and World Report 2017 Best Global Universities rankings.

    A campus with world-class facilities and one of the most visually spectacular settings in higher education, UC Santa Cruz offers rigorous academic programs and cutting-edge research opportunities. At the core of our progressive educational approach are our 10 distinctive residential colleges, which organize the campus into smaller living/learning communities.

    More information can be found here: admissions.ucsc.edu

    JOB SUMMARY

    Under the direction of the Associate Director for Fiscal and Administrative Services, the Operations and Policy Analyst is charged with a broad range policy research and analysis and additional administrative responsibilities that support the Office of Undergraduate Admissions. The incumbent initiates and/or manages special projects of an analytical nature and recommends innovative business solutions to address department needs within University policies and procedures. The incumbent must set priorities, multitask and see projects through to completion in a fast-paced organization.

    In consultation with Associate Director, the Operations and Policy Analyst performs transactions in a variety of financial systems and oversees the creation of fiscal best practices, procedures and unit emergency planning and preparedness including business continuity procedures housed in core technologies (Asana, Canvas, Google Suites), meeting and event planning. The incumbent will provide analytical and executive support to the Director, including special projects and events and problem solving. Duties also include oversight of special projects or assignments that may be complex in nature, requiring a high level of independence, initiative and discretion, and may handle details and oversee work of a highly confidential and critical nature to support the director. The Operations and Policy Analyst must think critically to identify creative solutions that increase business efficiencies, support on-going staff development, and enhance intra-office communications.

    APPOINTMENT INFORMATION

    Salary Information: Salary Range: $71,700 - $74,000 / Annually. Salary commensurate with skills, qualifications and experience.

    No. of Positions: 1

    Benefits Level Eligibility: Full benefits

    Schedule Information:
    • Full-time, Fixed
    • Percentage of Time: 100%, 40 Hours per Week
    • Days of the Week: Mon-Fri
    • Shift Includes: Day

    Employee Classification: This is a Career appointment

    Job End Date: None

    Work Location: UC Santa Cruz Main Campus / Remote

    Union Representation: Non-Represented

    Job Code Classification: 007398 (PROJECT POLICY ANL 3)

    Travel: Never or Rarely

    JOB DUTIES

    30% -
    • Researches and drafts complex proposals, reports, briefings, executive summaries, and speeches. Organizes ad hoc committees appointed by the director on a broad range of issues. Maintains a comprehensive database of initiatives and assignments, to include actions delegated. Briefs director on deadlines and status of pending issues. Proposes, leads and / or participates on policy and planning committees and working groups. Establishes and maintains contacts internally and with external constituents for the collection and exchange of data. Prepares directives, regulations, technical guidance, and other instructions for issuance to stakeholders. Coordinates implementation with cross-organizational departments or external entities as needed.

    25% -
    • Researches, monitors and analyzes regulations, legislation, research literature and UC policies for impact on and to guide a broader strategic direction for the organization. Researches organizational structures, policies and procedures and summarizes best practices in the field. Develops scope of work, budgets, and reports for project requirements.
    • Provides analyses for complex budget, financial, academic, data, systems and resource projects working directly with all levels of managers. Performs ad hoc, analytical studies on a wide variety of policies, programs and issues which are complex in nature.

    20% -
    • Oversees the creation and maintenance of departmental policies and associated guidelines/manuals. Develops and implements efficient and effective systems for managing information. Administers the development and coordination of policy communications; formulates strategies for distribution and enforcement.

    15% -
    • Prepares and reviews human resources and financial transactions in multiple systems, including: Banner, UCPath and FMW as needed.

    10% -
    • Other Duties as assigned.


    REQUIRED QUALIFICATIONS
    • Bachelor's degree in related area and / or equivalent experience / training.
    • Knowledge of common organization- or research-specific and other computer application programs.
    • Strong communication and interpersonal skills to communicate effectively, both verbally and in writing.
    • Ability to use discretion and maintain all confidentiality.
    • Analytical / problem-solving skills.
    • Strong skills in analyzing, researching and synthesizing large amounts of data for preparing sound and relevant proposals / analyses.
    • Ability to multi-task with demanding timeframes.
    • Strong policy analysis techniques.


    SPECIAL CONDITIONS OF EMPLOYMENT
    • Selected candidate will be required to pass a pre-employment criminal history background check.
    • Ability to move materials weighing up to 30 lbs. with or without accommodation.
    • The University of California has implemented a COVID-19 Vaccination Policy covering all employees. To be compliant with the policy, covered employees must submit proof of vaccination or have an approved exception or deferral, eight (8) weeks from date of hire.
    • Per the Child Abuse and Neglect Reporting Act (CANRA), this position has been identified as a Mandated Reporter. The selected candidate will be required to report known or suspected child abuse or neglect as defined by CANRA and will be required to sign a Statement Acknowledging Requirement to Report Child Abuse prior to commencing employment. CANRA Penal Codes, and related definitions, requirements, and responsibilities may be obtained here.


    SAFETY STATEMENT

    All UCSC employees must understand and follow job safety procedures, attend required health and safety training, proactively promote safety at work, and promptly report actual and potential accidents and injuries.

    HOW TO APPLY

    Attach your resume and cover letter when applying for this job opening. Do not attach any documents to 'My Activities'. Visit our How to Apply tutorial for detailed instructions on our applicant process.

    EEO/AA

    The University of California is an Equal Employment Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. UC Santa Cruz is committed to excellence through diversity and strives to establish a climate that welcomes, celebrates, and promotes respect for the contributions of all students and employees.


    APPLICANTS ARE REQUIRED TO USE THE UCSC ON-LINE PROCESS
    View full job description and access on-line application:
    https://careerspub.universityofcalifornia.edu/psp/ucsc/EMPLOYEE/HRMS/c/HRS_HRAM.HRS_APP_SCHJOB.GBL?Page=HRS_APP_JBPST&Action=U&FOCUS=Applicant&SiteId=11&JobOpeningId=40869&PostingSeq=1

    To ensure review of application materials by the hiring unit, they must be submitted on or before the initial review date (IRD) via the Staff Employment Opportunities web site; https://jobs.ucsc.edu. A computer is available at the UC Santa Cruz Staff Human Resources Office located at Scotts Valley Center. The Scotts Valley Center is located at 100 Enterprise Way, Suite E100, Scotts Valley, CA 95066. To learn more or to request disability accommodations, call 831-459-2009. Hearing impaired are encouraged to use the California Relay Service at 800-735-2922. UC Santa Cruz is an Equal Opportunity Employer.

    The University of California is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or protected veteran status. UC Santa Cruz is committed to excellence through diversity and strives to establish a climate that welcomes, celebrates, and promotes respect for the contributions of all students and employees.

    jeid-9667f1456119e747b7bc6deb53f0c53d
  • 20 Days Ago

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Project and Policy Analyst, Student Conduct and Conflict Education
  • University of California - Santa Cruz
  • Santa Cruz, CA FULL_TIME
  • JOB POSTING HOW TO APPLYFor full consideration, applicants should attach their resume and cover letter when applying for a job opening. For guidance related to the application process or if you are ex...
  • 16 Days Ago

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Coastal Science and Policy Associate Professor of Practice
  • University of California - Santa Cruz
  • Santa Cruz, CA FULL_TIME
  • Position overview Position title: Coastal Science and Policy Associate Professor of Practice (Associate Adjunct Professor, Fiscal Year) Salary range: Commensurate with qualifications and experience. A...
  • 14 Days Ago

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Medical Assistant
  • Dignity Health Medical Group
  • SCOTTS VALLEY, CA FULL_TIME
  • OverviewDignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affi...
  • 1 Month Ago

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Medical Office Rep II
  • Dignity Health Medical Group
  • SANTA CRUZ, CA FULL_TIME
  • OverviewDignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affi...
  • 18 Days Ago

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Medical Assistant Office Rep
  • Dignity Health Medical Group
  • Capitola, CA FULL_TIME
  • OverviewDignity Health Medical Foundation established in 1993 is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affi...
  • 1 Day Ago

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0 Medical Policy Specialist jobs found in Santa Cruz, 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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Intellectual Property Manager
  • Santa Cruz Nutritionals
  • Santa Cruz, CA
  • We believe being healthy should not require tradeoffs. SCN BestCo is a leading innovator, developer and manufacturer of ...
  • 4/24/2024 12:00:00 AM

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Travel Physical Therapist - $1,897 per week
  • Hiring Now!
  • Santa Cruz, CA
  • OneStaff Medical is seeking a travel Physical Therapist for a travel job in Santa Cruz, California. Job Description & Re...
  • 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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Senior Building Inspector
  • City of Santa Cruz, CA
  • Santa Cruz, CA
  • Salary : $6,723.00 - $9,460.00 Monthly Location : City of Santa Cruz, CA Job Type: Regular Full-Time Job Number: 24-004 ...
  • 4/23/2024 12:00:00 AM

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Executive Director
  • MHCAN
  • Santa Cruz, CA
  • JOB DESCRIPTION Position Title: Peer Run Drop In Executive Director Reports to: MHCAN Board of Directors If you are inte...
  • 4/22/2024 12:00:00 AM

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Code Compliance Specialist
  • City of Santa Cruz, CA
  • Santa Cruz, CA
  • Salary : $6,072.00 - $8,544.00 Monthly Location : City of Santa Cruz, CA Job Type: Regular Full-Time Job Number: 24-076 ...
  • 4/21/2024 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

Santa Cruz (/ˈsæntə ˈkruːz/, Spanish: Holy Cross) is the county seat and largest city of Santa Cruz County, California. As of 2013 the U.S. Census Bureau estimated Santa Cruz's population at 62,864. Situated on the northern edge of Monterey Bay, about 32 mi (51 km) south of San Jose and 75 mi (120 km) south of San Francisco, the city is part of the 12-county San Jose-San Francisco-Oakland Combined Statistical Area. Santa Cruz is known for its moderate climate, natural environment, coastline, redwood forests, alternative community lifestyles, and socially liberal leanings. It is also home to th...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$99,910 to $121,956
Santa Cruz, California area prices
were up 2.5% 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