Medical Policy Manager jobs in South Dakota

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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Program Manager, Western Markets & Policy (Relocate to South Dakota or Colorado!
  • Black Hills Energy
  • Rapid, SD FULL_TIME
  • Job Specifications

    As part of the Electric Utility planning and policy team this position is responsible for engaging in the design and development of western energy markets ensuring Black Hills' operational and financial objectives are met. Drives the development of strategy and policy recommendations related to organized markets in the west that Black Hills Energy may consider. This position will participate in organized market stakeholder processes driving policy and decisions that are supportive of Black Hills Energy's long-term goals.

    SALARY RANGE: $100,650 - $166,050 (Determined by the knowledge, skills and abilities of the applicant.)

    REPORTING RELATIONSHIP: Director, Electric Strategy, Planning & Policy

    LOCATION: Denver, Colorado or Rapid City, South Dakota

    • A comprehensive relocation package is offered for this position! Details about this package will be shared during the interview and offer process.

    ESSENTIAL JOB FUNCTIONS:

    • Develop and maintain effective working relationships with other transmission providers, regional transmission groups/associations, and transmission customers
    • Provide strategic leadership for local/regional transmission initiatives that support the overall goals and objectives of the Company
    • Work closely with the electric utilities' teams in integrating the activities of a market opportunities with particular focus on the safety, reliability, cost effectiveness.
    • Support good working relationships with various local, state and federal regulators and legislators, and their staffs as appropriate
    • Demonstrated ability to represent the Company in front of various stakeholders: employee groups, major customers, regulatory agencies, governmental officials, peer utilities and industry associations
    • Develop business recommendations for Black Hills Energy's positions, policies and messaging related to various organized market initiatives by conducting data analysis and engaging with the broader organization
    • Develop supporting material used for internal and external communications which relate to or impact the business interests including data request responses, testimony, regulatory filings, etc
    • Develop and maintain documentation that allows a third party to easily understand and replicate all analysis conducted
    • Coordinate internal discussions across business units to align on company positions regarding organized market and policy issues

    ADDITIONAL RESPONSIBILITIES:

    • Partner and collaborate with various internal departments ensuring alignment of goals, policies and expectations of utility markets in the west.
    • Effectively build coalitions within stakeholder processes to influence policy outcomes.
    • Engage with external parties aligning common goals through industry groups.

    QUALIFICATIONS:

    • Minimum of 7 years of regulatory, legal, business, engineering, utility industry or other related experience required. .
    • Bachelor's degree in Business, Engineering, Economics or other related field; or an equivalent combination of education and experience required.

    KNOWLEDGE/SKILLS/ABILITIES:

    • Demonstrated ability to self-direct workload and prioritize business needs.
    • Possess unquestionable integrity and excellent judgment.
    • Strong verbal and written communication skills. Ability to articulate, communicate and influence.
    • Ability to gather and communicate requirements, present alternatives and recommendations.
    • Ability to perform in high-pressure situations while maintaining focus and calmness.
    • Ability to provide timely assessments / evaluations.
    • Innovative thinking and the ability to adjust to quickly changing business needs.
    • Demonstrated project management and multi-functional leadership skills.

    This description is not intended to be an all-inclusive list of responsibilities, duties, and requirements for employees in this position. Job descriptions may and do change periodically. Where positions are covered by a collective bargaining unit agreement, the terms and conditions of the agreement will apply.

    About our Company: We are a customer, growth and safety focused utility company that is dedicated to our communities. We improve life with energy as an energy partner of choice. Our diverse culture fuels unique perspectives, opening doors to new insights and possibilities. Based in Rapid City, South Dakota, we have over 3000 employees and serve 1.3 million natural gas and electric utility customers across eight states (South Dakota, Montana, Wyoming, Colorado, Nebraska, Iowa, Kansas, and Arkansas).

    Enjoy our Comprehensive Benefits Package! Annual discretionary bonuses, 401(k) (6% company match and up to 9% company retirement contribution), tuition reimbursement, generous paid time off benefits, including paid holidays and parental leave, company paid life insurance and disability benefits (short and long term), an employee assistance program and well-being benefits, and competitive medical, dental and vision insurance.

    Candidates must successfully pass a pre-employment drug screen and background check.

    Black Hills Energy does not sponsor applicants for work visas. All applicants must be legally authorized to work in the US.

    We are an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age, or status as a protected veteran. If you require reasonable accommodation, please visit for more information.


    #denver #rapid


    EEO/AA/M/F/Vet/Disabled

     

  • 1 Month Ago

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MSP Manager
  • Wapiti Medical
  • Huron, SD FULL_TIME
  • OPEN POSITION - MUST WORK PRIMARILY WITHIN 150 MILES OF OUR HURON OR MILBANK, SD OFFICES. Wapiti is currently seeking a MSP Coordinator. This is a full-time position Monday-Friday with some periodic a...
  • 2 Days Ago

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Public Policy Associate IV
  • Pathward, National Association
  • Sioux Falls, SD FULL_TIME
  • We are a hybrid, remote-office company dedicated to growing our talent anywhere! We have onsite locations in: Sioux Falls, SD, Scottsdale, AZ, Troy, MI, Franklin, TN, Dallas, TX At Pathward, we take t...
  • 6 Days Ago

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Public Policy Associate IV
  • Pathward, N.A.
  • Sioux Falls, SD FULL_TIME
  • About the Role: Support government relations efforts in the achievement of the strategic policy and advocacy plan for Pathward. Provide support in the design and execution of effective advocacy strate...
  • 6 Days Ago

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Public Health Analyst (Policy)
  • Centers for Disease Control and Prevention
  • Rapid, SD FULL_TIME
  • As a global leader in public health & health promotion, CDC is the agency Americans trust with their lives. In addition to our everyday work, each CDC employee has a role in supporting public health e...
  • 7 Days Ago

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Senior Policy Program Specialist
  • Administration for Children and Families
  • Rapid, SD FULL_TIME
  • This position is located in the Department of Health and Human Services, Administration for Children and Families, Office of Refugee Resettlement, located in Anywhere in the U.S. (remote job). Salary:...
  • 9 Days Ago

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Orem, UT
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Fairfield, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Folsom, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco Animal Supplies Inc
  • Saratoga Springs, NY
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/28/2024 12:00:00 AM

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Medical Lead - Oncology, Medical Affairs
  • SEC Life Sciences
  • One of the world's leading pharmaceutical companies is seeking four passionate, forward-thinking individuals for key rol...
  • 3/28/2024 12:00:00 AM

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Hospital Medical Leader
  • Petco
  • Menifee, CA
  • Create a healthier, brighter future for pets, pet parents and people! If you want to make a real difference, create an e...
  • 3/27/2024 12:00:00 AM

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Executive Director, Head of Medical Affairs, Immunology
  • RBW Consulting
  • Philadelphia, PA
  • A major international pharma business is looking to expands its immunology pipeline and requires a dynamic and forward t...
  • 3/25/2024 12:00:00 AM

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Head of Medical Writing
  • Morgan Prestwich - Life Science & Healthcare Executive Search
  • Company Overview Morgan Prestwich is thrilled to be representing our client on an exclusive basis. Our client is a clini...
  • 3/24/2024 12:00:00 AM

South Dakota (/- dəˈkoʊtə/ (listen)) is a U.S. state in the Midwestern region of the United States. It is named after the Lakota and Dakota Sioux Native American tribes, who compose a large portion of the population and historically dominated the territory. South Dakota is the seventeenth largest by area, but the fifth smallest by population and the 5th least densely populated of the 50 United States. As the southern part of the former Dakota Territory, South Dakota became a state on November 2, 1889, simultaneously with North Dakota. Pierre is the state capital and Sioux Falls, with a populat...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Manager jobs
$115,054 to $140,461

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