Pay: The hourly pay rate range for this position is $56.12–$64.50, dependent on qualifications and experience.
Location: Hybrid MN, on-site 2 days a week
Hollstadt offers medical, dental, vision, life insurance, short-term disability, long-term disability, paid sick leave, and retirement benefits to eligible employees.
This position a key member of the team that develops and implements medical policies for the company. The incumbent will be responsible for ensuring that medical policy issues are circulated to internal stakeholders of the company at several stages before final implementation. The incumbent will be part of a team that ensures policies are implemented and integrated with all systems to ensure accurate claims processing. This will include reviewing and applying new codes to the medical policies, developing quality improvement processes for medical policy implementation, and assisting with data reporting needs, as they pertain to the policy decision making process. The incumbent will also organize communication of medical policy changes and serve as a liaison, within the Integrated Health Management division, for communication of medical policy issues. The Senior Medical Policy Consultant serves as a resource to other members of the Medical Policy team.
Required Skills and Experiences:
• 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 apply critical thinking skills to medical policy interpretation and implementation.
• Ability to work independently; well-organized and able to set priorities with minimal direction.
• 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.
• Ability to maintain relationships with internal and external stakeholders, clinicians, and others.
• 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.