Medical Policy Manager jobs in Arizona

Medical Policy Manager manages and implements corporate policy and process for medical provider and other reimbursements. Ensures that all claims are reviewed, settled, and processed in compliance with and according to contract provisions and regulatory requirements. Being a Medical Policy Manager evaluates and develops policies and provider reimbursement guidelines to effectively manage and control medical claims cost. Requires a bachelor's degree of finance, business or healthcare administration. Additionally, Medical Policy Manager typically reports to head of a unit/department. The Medical Policy Manager manages subordinate staff in the day-to-day performance of their jobs. True first level manager. Ensures that project/department milestones/goals are met and adhering to approved budgets. Has full authority for personnel actions. Extensive knowledge of department processes. To be a Medical Policy Manager typically requires 5 years experience in the related area as an individual contributor. 1 to 3 years supervisory experience may be required. (Copyright 2024 Salary.com)

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5372 - Public Health Policy Manager
  • Pima County
  • Tucson, AZ FULL_TIME
  • Salary Grade: 14

    Pay Range
    Hiring Range: $60,487 - $72,584 Annually
    Full Range: $60,487 - $84,682 Annually 


    Salary offers are based on the candidate's equivalent experience and internal equity with other employees within the same job classification.    

    As the Public Health Policy Manager, you will be involved in leading and facilitating public health policy initiatives for the Pima County Health Department as part of the broader objective to make Pima County one of the healthiest counties in the nation by 2030. In this capacity, you will engage in health policy research, advocate and support public policy interventions, and conduct policy education. The position is dedicated to fostering public health policy development that promotes health equity, addresses social determinants of health, collaborates on public health policy initiatives through partnerships, and provides technical assistance in policy, systems, and environmental changes for public health projects. Additionally, this role identifies and nurtures potential policy changes across various industry and government levels to advance health equity and enhance health promotion within a wide range of public policies. 

     

    In its capacity as the regional health authority, you will assist the health department in guiding all localities within Pima County to undertake initiatives aimed at enhancing the health of all residents. The manager will be instrumental in ensuring compliance with accreditation requirements, implementing strategic plan objectives, and offering thought leadership in the realm of public health policy. 

     

    This position is in the Office of Policy, Resilience, and Equity, which operates within a framework that aids staff and programs in fostering stronger collaborations with the community, tackling health disparities, enhancing (DEI) capabilities, and proficiently influencing policy and systems to equitably address the health needs of Pima County residents. In this role you will oversee a staff of two. 

        (Work assignments may vary depending on the department's needs and will be communicated to the applicant or incumbent by the supervisor.)

    Develops program goals, objectives, policies and procedures and establishes short- and long-range program performance plans subject to management review;

    Manages and administers program activities and evaluates program effectiveness and success;

    Develops, negotiates, monitors, and administers contracts, intergovernmental agreements, and/or financial and service agreements for the program managed;

    Monitors program contract compliance and takes corrective action as required;

    Performs as a program representative within the community, delivers informational news releases, serves as a program contact person and participates in community awareness activities;

    Develops and maintains effective working relationships and coordinates program activities with other county departments, public and private agencies, organizations and groups to promote the program and its goals;

    Analyzes federal, state and local legislation and ensures program compliance with applicable regulations and policies;

    Directs organizational and management studies for the purpose of identifying problems and alternative solutions to the problems;

    Develops, writes and administers the program's annual budget, prepares program-related financial forecasts and identifies funding sources to support program activities;

    Reviews and analyzes routine and special reports detailing the status and/or success of the program, prepares recommendations and/or initiates corrective action;

    Evaluates management problems and makes decisions regarding the proper course of action;

    May supervise the activities of county staff and evaluate performance;

    May make recommendations to the Board of Supervisors regarding program objectives;

    May direct the preparation and submittal of proposals and grant applications;

    May access or maintain specialized databases containing program-specific information to review information or generate reports.

    KNOWLEDGE & SKILLS:

    Knowledge of:
    • principles and procedures of public administration, management, and program planning, development, and evaluation;
    • federal, state and local laws, rules and regulations;
    • principles and practices of budgeting, accounting, purchasing, contracting and financial management;
    • contract and grant application preparation, negotiation and administration;
    • community agencies, organizations and resources;
    • data and statistical analysis techniques and application to planning studies and projects;
    • principles and techniques of effective communication to include written composition and public speaking;
    • applications of automated information systems.
       
    Some positions within this classification require knowledge of program-specific terminology, principles, practices and procedures.

    Skill in:
    • planning, developing, evaluating and managing programs and projects;
    • preparing and administering budgets, grants and contracts;
    • researching, analyzing and reporting data;
    • presenting, explaining and interpreting program goals, objectives, policies and procedures to the public;
    • directing staff and planning, organizing and coordinating program activities;
    • communicating effectively;
    • establishing and maintaining effective working relationships with service groups and organizations;
    • establishing, reviewing and modifying procedural and technical guidelines to enhance program effectiveness;
    • use of automated information systems to maintain or produce data.

    (1) Bachelor's degree from an accredited college or university and four years of professional level experience in coordinating, monitoring, administering or managing program or specialized work unit activities. 

    (Relevant professional level experience and/or education from an accredited college or university may be substituted.)

    OR:

    (2) One year of experience with Pima County as a Program Coordinator.

    Qualifying education and experience must be clearly documented in the "Education" and “Work Experience" sections of the application. Do not substitute a resume for your application or write "see resume" on your application.

    Preferred Qualifications: (Be specific in describing your experience in your application. Ensure the descriptions provided illustrate your competencies, specifically addressing the required and preferred qualifications.):

    1. Master’s degree in public health, health policy, business administration, healthcare administration, or related field. 
    2. Experience in analyzing, evaluating, and developing public health policy and regulatory proposals at both the organizational and legislative levels.
    3. Experience working with key government officials, community stakeholders, intradepartmental senior leadership, and other key community-based organizations in the development of population health-based policy. 
    4. Minimum two (2) years experience facilitating group meetings, focus groups, community forums, and working in multi-disciplinary, multi-cultural, and multi-sectoral partnerships.
    5. Experience developing and implementing health policy at both organizational and legislative levels or other strategic plans related to public policy. 
    6. Minimum two (2) years experience supervising a team of professionals.

    Selection Procedure
    Pima County Human Resources Department reserves the right to admit to the selection process only those candidates that meet the minimum/desired qualifications. All applications will be assessed based on an evaluation of the listed education and experience. Candidates meeting the minimum/desired qualifications may be further evaluated/scored against any advertised Preferred Qualifications. The hiring authority will interview and select the successful candidates from a referral list provided by Human Resources. Additional assessments/testing may be required as part of the selection process.   

    Licenses and Certificates: Valid driver license is required at time of application. Valid AZ driver license is required at time of appointment. The successful applicant will be subject to a 39-month DOT Motor Vehicle Record review to determine applicant’s suitability to operate county vehicles in accordance with Pima County administrative procedures. Failure to obtain and maintain the required licenses and certifications shall be grounds for termination. Any offer of employment resulting from this recruitment is contingent upon Fleet Services’ review and approval of the candidate’s driving record.     

    Special NoticeThe County requires pre-employment background checks. Successful candidates will receive a post-offer, pre-employment background screening to include verification of work history, education, and criminal conviction history.  A prior criminal conviction will not automatically disqualify a candidate from employment with the County. Some positions within this classification may require irregular work schedules and/or travel and may carry a low risk of exposure to infectious diseases. Therefore, special medical screening prior to or during employment may be necessary to ensure employee health and safety. Some positions within this classification may require satisfactory completion of a personal background investigation, polygraph test, and/or drug screening by law enforcement agencies at time of appointment. 

    Physical/Sensory Requirements: Physical and sensory abilities will be determined by position.

    EEO Information: Pima County Government is an Equal Employment Opportunity employer. We are committed to an inclusive and diverse workforce and will not discriminate in employment opportunities or practices on the basis of race, color, religion, national origin, age, disability, gender, sexual orientation, kinship, political interest, or any other characteristic protected by law.

  • 10 Days Ago

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  • Phoenix, AZ FULL_TIME
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  • Houston, TX
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  • Waltham, MA
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Executive Director, Head of Medical Affairs, Immunology
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  • Philadelphia, PA
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Arizona (/ˌærɪˈzoʊnə/ (listen); Navajo: Hoozdo Hahoodzo Navajo pronunciation: [xòːztò xɑ̀xòːtsò]; O'odham: Alĭ ṣonak Uto-Aztecan pronunciation: [ˡaɺi ˡʂonak]) is a state in the southwestern region of the United States. It is also part of the Western and the Mountain states. It is the sixth largest and the 14th most populous of the 50 states. Its capital and largest city is Phoenix. Arizona shares the Four Corners region with Utah, Colorado, and New Mexico; its other neighboring states are Nevada and California to the west and the Mexican states of Sonora and Baja California to the south and so...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$127,443 to $155,582

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