Correspondence Policy Specialist
Location
United States
Posted
10 days ago
Salary
Not specified
No structured requirement data.
Job Description
Role Description
This role involves working with a highly skilled team of specialists responsible for the development, approval, and maintenance of corporate clinical correspondence.
- Develops and customizes correspondence according to regulatory and contractual requirements.
- Provides oversight of the use of appropriate correspondence and reviews requests for new or modifications to existing correspondence templates.
- Oversees clinical correspondence for all products in collaboration with Compliance.
- Updates clinical correspondence templates to meet minimum standards for various regulatory bodies.
- Tasked with problem solving and negotiation with internal and external customers.
- Researches state regulatory requirements for clinical correspondence and policies.
- Consults with IT to support the letter generation process.
Qualifications
- 3+ years of healthcare industry experience - Required
- 3+ years of experience with compliance and quality requirements related to healthcare and UM processes - Required
- Associates preferred but consideration for 2 or more additional years of experience will be considered
- Analytical/problem solving skills - Required
- Strong interpersonal, consultation, organizational, tracking and follow-up skills - Required
- Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups - Required
- Excellent verbal and written communication skills - Required
- Knowledge of legislative/oversight bodies (e.g., URAC, ERISA, CMS) - Required
Requirements
- High speed internet over 10 Mbps.
- Ability to plug in directly to the home internet router for call center employees.
Benefits
- Comprehensive health insurance benefits.
- Bonus component dependent on pre-defined performance factors.
Company Description
Evolent partners with health plans and providers to achieve better outcomes for people with complex and costly health conditions.
- Focus on connecting the pieces of the fragmented health care system.
- Commitment to diversity and inclusion.
- Employees enjoy work/life balance and flexibility.
Job Requirements
- 3+ years of healthcare industry experience - Required
- 3+ years of experience with compliance and quality requirements related to healthcare and UM processes - Required
- Associates preferred but consideration for 2 or more additional years of experience will be considered
- Analytical/problem solving skills - Required
- Strong interpersonal, consultation, organizational, tracking and follow-up skills - Required
- Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups - Required
- Excellent verbal and written communication skills - Required
- Knowledge of legislative/oversight bodies (e.g., URAC, ERISA, CMS) - Required
- High speed internet over 10 Mbps.
- Ability to plug in directly to the home internet router for call center employees.
Benefits
- Comprehensive health insurance benefits.
- Bonus component dependent on pre-defined performance factors.
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