Medical Policy Specialist jobs in Colorado

Medical Policy Specialist researches and designs criteria to determine policy guidelines used in review of patient cases to ensure only medically appropriate services are reimbursed. Recommends a policy and process that ensure alignment with company guidelines and nationally accepted medical/coding standards. Being a Medical Policy Specialist establishes the proper codes to use for claims processing. Responds to questions from medical staff and communicates details about policy and guidelines. Additionally, Medical Policy Specialist requires a bachelor's degree. Typically reports to a supervisor or manager. Requires Registered Nurse RN. The Medical Policy Specialist gains exposure to some of the complex tasks within the job function. Occasionally directed in several aspects of the work. To be a Medical Policy Specialist typically requires 2 to 4 years of related experience. (Copyright 2024 Salary.com)

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Prevention and Policy Specialist I/II - TEPP
  • El Paso County (CO)
  • Colorado, CO FULL_TIME
  • Join our team as a Policy and Prevention Specialist in our Tobacco Education and Prevention Partnership! We are seeking a dynamic individual with a strong background in community health promotion, coalition management, and public health initiatives.


    The ideal candidate possesses excellent networking and outreach skills, along with a keen interest in developing and maintaining professional relationships with community partners to further program interests, along with excellent public speaking abilities. . Responsible for leading and assisting in multiple areas, including providing support and presentations for school communities, various policy efforts, and providing education for cessation services.


    Key duties include participating in multi-disciplinary team meetings, managing coalitions, community outreach, advocating for public health initiatives, and contributing to program planning and development. If you have a passion for community health, exceptional organizational skills, and a commitment to promoting public health, we invite you to apply and become an integral part of our impactful team TODAY!!!


    Prevention and Policy Specialist I - TEPP
    Full Salary Range PPS I: $48,710.00 - $70,620.00 Annually
    Hiring Range PPS I : $50,225.00 - $58,425.00 annually

    Prevention and Policy Specialist II - TEPP 
    Full Salary Range PPS II: $48,710.00 - $70,620.00 Annually
    Hiring Range PPS II: $58,425.00 - $63,550.00 annually


    This position has an anticipated work schedule of Monday – Friday, 7:30am -- 4:00pm or 8:00am – 4:30pm, subject to change. Under FLSA guidelines, this position is non-exempt.
    Eligible for hybrid work after a minimum of 3 months of employment and pending operational need.

    Position may require occasional evening and weekend hours to accommodate community presentations and special events.

    Works with El Paso County Public Health's Tobacco Education and Prevention Partnership (TEPP) by collaborating with partner agencies and community members to implement tobacco control evidence-based strategies that help adults and youth quit tobacco, prevent youth from starting tobacco, and decrease exposure to secondhand smoke. Assesses community needs and develops targeted health promotion materials, media/communication strategies, and educational approaches to address public health issues with diverse groups and community partners. This position is part of the Policy and Prevention Specialist - TEPP career progression series, which includes Policy and Prevention Specialist I - TEPP and Policy and Prevention Specialist II – TEPP. An employee is eligible to advance to the next position within the series when the employee has met the criteria for advancement as notated within the job description and has received a recommendation from the Hiring Authority.

    • Assesses individual and community needs for target populations and effectively advances programs and services.
    • Participates in multi-disciplinary team meetings to address the needs of the program and assists in the development and coordination of strategic program plans.
    • Collaborates with other staff to manage coalitions including strategic efforts, meeting planning and facilitation, general coalition building, recruitment and relationship maintenance, and coalition communication.
    • Builds, leads, and/or facilitates community coalitions, partnerships, and collaborations to support and advance work that may include youth coalitions and youth-adult partnerships. Works with key stakeholders and community partners to advocate for programs and policies that advance public health.
    • Conducts research on evidence-based programs for the purposes of program planning and development.
    • Develops and monitors program components (goals, objectives, strategies, interventions, and activities) in a structured format to address health education and public health objectives using evidenced-based strategies.
    • Makes recommendations for evidence-based strategies to improve public health and policy development.
    • Plans programming for target populations using a variety of educational approaches to include small and large group presentations, and development and implementation of earned and paid media campaigns.
    • Engages a variety of community stakeholders to increase support for program initiatives by providing education and training. Uses community input to develop, improve, and evaluate program activities, services, and policy initiatives.
    • Assesses community readiness for program/policy implementation. Assesses community partner readiness to meet program goals and drafts written agreements when needed.
    • Develops, coordinates, and maintains relevant health and wellness program resources. Evaluates the effectiveness of programs and educational materials, using a variety of evaluation tools.
    • Responds promptly to community members seeking health promotion information and resources.
    • Assists in budget development, expenditure monitoring, and informing program fiscal needs.
    • Develops a variety of communication materials for multiple audiences.
    • Participates in the agency's emergency planning and response activities.
    • Takes personal responsibility to provide exceptional customer service in order to promote and maintain a positive Public Health image, constructive working environment, and foster pride and professionalism in the workplace and community.
    • Promotes overall public health within the community.
    • Performs other duties as required.

    Knowledge, Skills, and Abilities:

    • Knowledge of and ability to independently research program subject matter.
    • Skill in using a computer and various software packages including Microsoft Office.
    • Excellent written and verbal communication skills to include presentations for large audiences. Ability to write and maintain clear, concise, and accurate records and reports.
    • Ability to communicate, motivate, and organize projects among a broad spectrum of people, frequently under deadline pressure. Ability to establish and maintain effective working relationships with the public, co-workers, federal, state, and local authorities, and other agencies.
    • Ability to prioritize and organize multiple tasks and complete projects in a timely manner. Ability to respond in a flexible manner and reprioritize work as situations change.
    • Ability to demonstrate sound judgment and critical thinking. Ability to identify problems and work to resolve them.
    • Knowledge and understanding of agency policies and procedures.
    • Ability to maintain the security of sensitive and confidential information.
    • Ability to work independently and in a team environment.
    • Maintain regular and punctual attendance. 

    Required Education and Experience:

    • Bachelor's degree from an accredited college or university with a major in health education, public health, public policy, or related field.
    • Any equivalent combination of related education and work experience that satisfy the requirements of the job will be considered.

    Level II requirements:

    • Two years full-time professional related experience. 
      • A Master's degree in health education, public health, public policy, or related field may substitute for one year of the required experience.

    Preferred Education and Experience:

    • Previous experience with health promotions outreach, coalitions, public health, youth development, adult learning principles and/or meeting coordination and facilitation.

    Licenses/Certificates:

    • Must possess and maintain a valid driver's license.

    Pre-Employment Requirements:

    • Must pass conditional post offer background investigation, motor vehicle record check, drug screen, and physical examination.

    Duties are conducted in an office and field environment. Work environment may include potential exposure to second-hand smoke and other environmental hazards. Local travel is required; work may be assigned in various locations. Will be required to work evenings and weekends as business needs dictate. Must be able to safely lift and carry up to 25 lbs. Public Health employees are responsible for providing proof of vaccinations and/or tuberculosis testing as applicable to the specific position and must provide proof of completion of required vaccinations/testing or proof of initiation within sixty days of hire date. 

  • 3 Days Ago

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Information Technology Specialist (Policy and Planning), GG-2210-11
  • U.S. Army Cyber Command
  • Carson, CO FULL_TIME
  • Duties Serve as an IT Project Manager/Change Management/IT Operations specialist in the Business and Plans Division for Western Region Network Enterprise Center (RNEC) and supported local Network Ente...
  • 9 Days Ago

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SUPERVISORY IT SPECIALIST (POLICY AND PLANNING/INFOSEC)
  • U.S. Army Cyber Command
  • Peterson, CO FULL_TIME
  • Duties Provide defensive cyberspace assessments associated with operations planning to include activities with computer network exploitation and attack. Provide advice and assistance to Component Comm...
  • 14 Days Ago

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ADF-C IT Policy/Governance Specialist
  • MCR, LLC
  • Denver, CO FULL_TIME
  • ADF-C IT Policy/Governance Specialist Job Locations US-CO-Denver ID 2024-18368 Category Program Analysis Security Clearance Requirement Top Secret/SCI with CI Poly Type Regular Full-Time Overview Syst...
  • 15 Days Ago

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Medical Records Specialist
  • The Medical Center of Aurora
  • Aurora, CO FULL_TIME
  • Hourly Wage Estimate: $18.29 - $24.30 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that may be used ...
  • Just Posted

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Medical record specialist
  • Sky Ridge Medical Center
  • Lone Tree, CO FULL_TIME
  • Description Hourly Wage Estimate : $18.29 - $24.30 / hour Learn more about the benefits offered for this job. The estimate displayed represents the typical wage range of candidates hired. Factors that...
  • 17 Days Ago

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Ambulatory Medication Specialist
  • Children's National Medical Center
  • Washington, DC
  • Under the direct supervision of a registered pharmacist and under the leadership the Pharmacy Management staff, the Ambu...
  • 3/28/2024 12:00:00 AM

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Medical Specialist 2
  • New York State Civil Service
  • Thiells, NY
  • Agency People With Developmental Disabilities, Office for Title Medical Specialist 2 Occupational Category Health Care, ...
  • 3/28/2024 12:00:00 AM

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Medical Specialist - Pulmonology - Gary, IN
  • Regeneron Pharmaceuticals
  • Indianapolis, IN
  • The Medical Specialist (Sales Representative), Pulmonology (MS) will be responsible for engaging Pulmonologists and othe...
  • 3/28/2024 12:00:00 AM

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(Physician) Medical Specialist 2
  • Office for People with Developmental Disabilities
  • Thiells, NY
  • Job Description Job Description EMPLOYMENT OPPORTUNITY ANNOUNCEMENT EOA #: 23-061RR EOA DATE: March 15, 2024 REPLY BY: S...
  • 3/27/2024 12:00:00 AM

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Medical Assistant/ Medication Specialist
  • Nidraveda PA
  • San Antonio, TX
  • Job Description Job Description We are looking for someone with a professional attitude, a dedication to healthcare, and...
  • 3/27/2024 12:00:00 AM

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Medication Specialist
  • Behavorial Health Network, Inc
  • Boston, MA
  • Use your knowledge of addiction recovery and medication management with BHN! Join our team of competent and compassionat...
  • 3/26/2024 12:00:00 AM

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Medical Assistant, Medical Specialists
  • UP Health System - Marquette
  • Marquette, MI
  • UP Health System - Marquette Medical Assistant, Medical Specialists, 1.0DV Who We Are: People are our passion and purpos...
  • 3/26/2024 12:00:00 AM

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Medical Specialist 2
  • StateJobsNY
  • Queens Village, NY
  • MMINIMUM QUALIFICATIONS: Possession of a license to practice medicine in New York State (see limited permit option below...
  • 3/25/2024 12:00:00 AM

Colorado (/ˌkɒləˈrædoʊ, -ˈrɑːdoʊ/ (listen), other variants) is a state of the Western United States encompassing most of the southern Rocky Mountains as well as the northeastern portion of the Colorado Plateau and the western edge of the Great Plains. It is the 8th most extensive and 21st most populous U.S. state. The estimated population of Colorado was 5,695,564 on July 1, 2018, an increase of 13.25% since the 2010 United States Census. The state was named for the Colorado River, which early Spanish explorers named the Río Colorado for the ruddy silt the river carried from the mountains. The...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$90,173 to $110,071

Medical Policy Specialist in Norfolk, VA
Guideline 9 – specialist medical procedures provides that applications for the separate representation of children with an intellectual impairment in relation to applications for special medical procedures are not subject to the means test or merits test.
February 20, 2020