Senior Medical Policy Implementation Consultant

at  Blue Cross Blue Shield of Minnesota

ABOUT BLUE CROSS

Blue Cross and Blue Shield of Minnesota is one of the most recognized and trusted health care brands in the world with 2.5 million members. We’re committed to reinventing health care to improve health for our members and the community. We hope you’ll join us.

REQUIRED SKILLS AND EXPERIENCES:

• 6+ years of related professional experience. All relevant experience including work, education, transferable skills, and military experience will be considered.
• 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, strong communication, and efficiently managing work.
• Experience mentoring either in 1:1 relationship with a new hire or by sharing best practices and skills with peers and team as a whole.

This position a key member of the team that develops and implements medical policies for Blue Cross. The incumbent will be responsible for ensuring that medical policy issues are circulated to internal partners 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 Implementation Consultant serves as a resource to other members of the Medical Policy team.