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Director of Medical Policy
Posted on 1/27/2023
INACTIVE
Locations
Cedar Rapids, IA, USA
Experience Level
Entry
Junior
Mid
Senior
Expert
Desired Skills
Communications
Requirements
  • Bachelor's degree or direct and applicable work experience
  • Clinical experience required
  • 7+ years of program/project experience that reflects successful management of medical policy in managed care setting, including knowledge of relevant regulations (e.g. URAC, NCQA, HIPAA, PHI, etc.) and demonstrated experience utilizing critical thinking to evaluate complex systems and processes; create and implement recommended changes to processes and organizational structure to increase quality and efficiencies
  • Demonstrated leadership experience, including building/developing high performing teams. Establishes clear goals/expectations and motivates teams to achieve success
  • Demonstrates passion for member advocacy, service excellence, and quality member/patient care
  • Very strong change management skills. Creates a clear view of future state and inspires others to advance the vision
  • Effective critical thinking, problem solving, and research skills; analytical and uses data to inform decisions
  • Strong interpersonal and communication skills
  • Forward thinking, proactive, and a thoughtful approach to initiative prioritization; skilled at moving from strategy into tactics and operations
  • Creative thinker who drives the identification of continuous improvement opportunities
  • Master's degree in related field
  • End-to-end Medical Policy experience
  • Involvement in transformational health care initiatives/projects
Desired Qualifications
  • 10+ years of related experience is preferred. Health plan experience is a plus
Wellmark

1,001-5,000 employees

Mutual insurance provider
Company Overview
Wellmark’s mission is to provide a broad array of high quality, accessible, affordable, and cost competitive health insurance products and services. The company is committed to delivering affordable and sustainable healthcare options by collaborating with various health-care partners to ultimately deliver a greater quality of health and life to future generations.
Benefits
  • Medical and prescription drug coverage
  • Dental coverage
  • Vision plan
  • Compensation: comprised of two components: base pay or annual salary, and potential pay from the Performance Incentive Program (PIP), awarded annually when financial and customer measures are successfully achieved.
  • Financial Benefits: competitive financial benefits through a generous 401(k) savings and investment plan.
  • Educational assistance
  • Pathways to Wellness incentives
  • Employee Assistance Program
  • Time off
Company Core Values
  • Use your strengths
  • Develop your story
  • Focus your health