Medical Policy Specialist jobs in Worcester, MA

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)

U
Applied Public Policy Graduate Fellow
  • University of Massachusetts Medical School
  • Shrewsbury, MA OTHER
  • Overview

    Under the direction of the assigned manager, the Applied Public Policy Graduate Fellow (APP Graduate Fellow) will provide currently enrolled graduate students and recent masters and doctoral graduates with an exceptional hands-on experience in managing health and health care policy, financing, research, and service delivery systems, working in the effective and efficient administration of Massachusetts state-level health and human services programs. These tasks may be administrative or research oriented, depending on the department. Assigned projects will require advanced analytical and communications skills. For research-based departments, the Graduate Fellow will be responsible for complex laboratory tasks. Primary communications will be in a team environment within assigned department and will be focused on collecting the appropriate input for the assigned projects. As part of the educational component, participants will meet to make basic presentations highlighting the policy choices, challenges, and decision options that they discover regarding the work in which they are engaged. Specific job responsibilities will vary by department but may include information gathering, analysis, writing, editing and/or laboratory work. This is a temporary, non-benefited role.

    Responsibilities

    Administrative• Perform complex and varied executive/administrative tasks which require a high degree of independent action and the setting of priorities and procedures.• Conduct advanced research to assist other team members.• Create reports and perform in-depth data analysis.• Implement and manage tasks in accordance with departmental objectives.• Create and deliver basic presentations highlighting policy choices, challenges, and decision options that they discover regarding the work in which they are engaged• Perform assigned project tasks within specified timeframes.• Perform other duties as required • Meet and Report weekly to an assigned professional Mentor.

    Research• Perform complex experiments according to written protocols.• Perform advanced statistical analysis of data, genetic analysis and/or clinical studies.• Perform advanced library searches, reading and copying relevant materials.• Perform complex laboratory maintenance tasks.• Operate research equipment (i.e. scintillation counters, microscopes, centrifuges, balances) and record results.• Prepare laboratory media and solutions.

    Qualifications

    REQUIRED EDUCATIONMaster’s Degree (or Master’s Degree Candidate with 21 Credits earned) Applicants must have completed their master’s degree, or may be a currently enrolled graduate student with at least 21 earned credits. REQUIRED WORK EXPERIENCEAdvanced analytical and communication skills Attention to detail with the ability to collect and record information from a wide variety of sources Ability to use standard office tools and software (MS-Office) Must be reliable and able to set consistent work hours PREFERRED EDUCATIONEarned Doctorate, Certificate of Advanced Graduate Studies Applicants may have completed their master’s degree, or doctoral coursework, Certificate of Advanced Graduates Studies (CAGS), or doctoral degree, or be in the final semester of their master’s or CAGS, or in the final year of their doctoral or other advanced degree coursework.

    PREFERRED WORK EXPERIENCERelated experience preferred

    Additional Information

    Through project management of programs, the position supports the Commonwealth’s recruitment (i.e., growth) and retention of direct care workers.

  • 12 Days Ago

T
Lawn Specialist - Earn $13-$22/Hour + Benefits
  • TruGreen - Lawn Specialist
  • Marlborough, MA FULL_TIME
  • TruGreen is Now Hiring Lawn Specialists! Earn Up to $22.00 per Hour - Comprehensive BenefitsAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A caree...
  • 6 Days Ago

T
Lawn Specialist - Earn $13-$22/Hour + Benefits
  • TruGreen - Lawn Specialist
  • Shrewsbury, MA FULL_TIME
  • TruGreen is Now Hiring Lawn Specialists! Earn Up to $22.00 per Hour - Comprehensive BenefitsAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A caree...
  • 6 Days Ago

T
Lawn Specialist - Earn $13-$22/Hour + Benefits
  • TruGreen - Lawn Specialist
  • Leominster, MA FULL_TIME
  • TruGreen is Now Hiring Lawn Specialists! Earn Up to $22.00 per Hour - Comprehensive BenefitsAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A caree...
  • 7 Days Ago

A
Medical Specialist
  • ArmyRecruiting Albany
  • Fitchburg, MA FULL_TIME
  • Addresses jobs in the medical, dental and veterinary fields. These MOSs cover a variety of responsibilities throughout the military health care field, from clinical settings to point of injury.Basic Q...
  • 9 Days Ago

P
Project Manager
  • PuroClean Certified Restoration Specialist of...
  • Auburn, MA FULL_TIME
  • Project Manager Perks: Online Mobile Courses Flexible Scheduling Paid Training for Career Advancement Opportunity to Help People in Times of Need Aggressive Competitive Wages Company and Culture: Puro...
  • 1 Month Ago

Filters

Clear All

  • Filter Jobs by companies
  • More

0 Medical Policy Specialist jobs found in Worcester, MA area

L
Senior Paralegal/Nurse Paralegal
  • LHH
  • Boston, MA
  • LHH Recruitment Solutions is seeking an experienced Paralegal for Boston's premiere medical malpractice and personal inj...
  • 4/19/2024 12:00:00 AM

S
Support Advocate // Registered Behavior Technician
  • Seven Hills Foundation
  • West Boylston, MA
  • Overview $2,000.00 Sign-On Bonus for new hires $250.00 bonus for new hires already MAP Certified Under supervision of th...
  • 4/19/2024 12:00:00 AM

T
Patient Care Assistant Cardiac Stepdown Full Time Days
  • Tenet Health
  • Worcester, MA
  • Job Description Saint Vincent Hospital offers a whole new experience in health care. By combining our advanced, state-of...
  • 4/18/2024 12:00:00 AM

G
Claims Examiner –Remote
  • Generis Tek Inc
  • Boston, MA
  • Please Contact: To discuss this amazing opportunity, reach out to our Talent Acquisition Specialist Abhinav Chakraborty ...
  • 4/18/2024 12:00:00 AM

P
Center Medical Specialist - EMT/A - Cranston, RI $3,000 Sign On Bonus
  • PSG Global Solutions
  • Cranston, RI
  • Do you want to join an international team working to improve the future of healthcare? Do you want to improve the lives ...
  • 4/16/2024 12:00:00 AM

L
Senior Paralegal/Nurse Paralegal
  • Lhh
  • Boston, MA
  • LHH Recruitment Solutions is seeking an experienced Paralegal for Boston's premiere medical malpractice and personal inj...
  • 4/16/2024 12:00:00 AM

L
Nurse Attorney/Attorney/Senior Paralegal
  • Lubin & Meyer Pc
  • Boston, MA
  • Lubin & Meyer PC Boston's premiere medical malpractice and personal injury law firm is seeking an experienced Nurse Atto...
  • 4/16/2024 12:00:00 AM

M
Claims Adjuster - Personal Injury
  • Marasco & Nesselbush Llp
  • Providence, RI
  • Claims Adjuster Personal Injury Come join a growing team of well-respected attorneys and professionals. Marasco & Nessel...
  • 4/16/2024 12:00:00 AM

Worcester has a total area of 38.6 square miles (100 km2), 37.6 square miles (97 km2) of land and 1.0 square mile (2.6 km2) (roughly 2.59%) of water. Worcester is bordered by the towns of Auburn, Grafton, Holden, Leicester, Millbury, Paxton, Shrewsbury, and West Boylston. Worcester is known as the Heart of the Commonwealth, because of its proximity to the center of Massachusetts. The city is about 40 miles (64 km) west of Boston, 50 miles (80 km) east of Springfield, and 38 miles (61 km) northwest of Providence, Rhode Island. The Blackstone River forms in the center of Worcester by the conflue...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$94,364 to $115,187
Worcester, Massachusetts area prices
were up 1.6% 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