Description: Judge Healthcare is currently seeking a Medical Policy Implementation Consultant for a Hybrid opening in Eagan, MN for one of our biggest clients!
Type: Contract- 6+ months
Hours: Mon- Fri, 8:30am- 4:30pm
Location: 2 days a week at Eagan, MN 55122, remote 3 days a week!
Pay: Flexible and based on experience
Responsibilities:
Support AuthAI Implementation
Clinical decision tree validation, by comparing clinical decision tree to medical policy, to ensure alignment
Testing support once AuthAI is implemented
Present and provide implementation input to key medical policy committees: Medical and Behavioral Health Policy Committee, Coverage Committee, and Operational committees as assigned for example, Coding and Reimbursement Committee, and Medical Policy Prep Committees
Prepare final policy documents and tools for implementation.
Implement medical policies-integrates with all systems to ensure accurate claims processing.
Assure that changes in medical policies are communicated to all lines of business, including Medicare, and others as needed.
Research and apply appropriate and regular updates of CPT, HCPCS, and ICD-9/ICD-10 coding to the medical policies.
Qualifications:
Bachelors or Masters degree in health related field
5+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
Registered Nurse with strong understanding of medical policy interpretation as it relates to prior authorization processing
Ability to effectively communicate both verbally and in writing.
Strong PC skills; Excel, PowerPoint, Visio, Word, and internet based programs.
Ability to develop and work on several projects at one time in a fast paced environment.
Project management experience.
Demonstrated positive professionalism in all work-related behaviors as demonstrated by adaptability, contributing to team success, customer focus, skillful communication, and efficiently managing work.
Are you interested or know someone that might be interested? Reach out to Britney Bishop with an updated resume to bbishop@judge.com for immediate consideration!
Contact: bbishop@judge.com
This job and many more are available through The Judge Group. Find us on the web at www.judge.com
