Medical Policy Specialist jobs in Delaware

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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Environmental Specialist IV - Sr. Climate Change Policy Spec
  • State of Delaware - DNREC (40)
  • Dover, DE FULL_TIME
  • Introduction

    The DNREC Climate and Sustainability Section is charged with reducing the greenhouse gas emissions that cause climate change and improving Delaware's resiliency to impacts of climate change. Click here for more information about the Climate and Sustainability Initiatives within the Division of Climate, Coastal and Energy.

    Summary Statement

    The position is the lead for technical analysis of greenhouse gas (GHG) emissions strategies and modeling of future conditions in Delaware. This position also coordinates updates to the Delaware Greenhouse Gas Inventory with staff from DNREC’s Division of Air Quality. Responsibilities also include leading a new workgroup of technical experts in developing GHG emissions projections and improving Delaware’s GHG emissions modeling. The position is the lead for developing and writing strategies and actions used in the 2025 Delaware Climate Action Plan and coordinating contributions from other team members and external partners. This position is part of the team who will conduct community and stakeholder engagement for the 2025 Climate Action Plan.

    Essential Functions

    Essential functions are fundamental, core functions common to all positions in the class series and are not intended to be an exhaustive list of all job duties for any one position in the class. Since class specifications are descriptive and not restrictive, incumbents can complete job duties of similar kind not specifically listed here. Performs environmental specialist work in an environmental specialty area such as wildlife/endangered species, wetlands and vegetation, noise, air quality, civil rights, architecture/historic properties, and archaeology sites. � Provides guidance and technical assistance to engineering and project personnel, representatives from local, state and federal agencies, and project stakeholders to incorporate environmental and sociocultural considerations into project and/or program activities. � Ensures that State project and/or program plans, construction and maintenance are all in compliance with local, state and federal laws, rules and regulations related to water quality, wetlands, air quality, noise, wildlife, civil rights, historic preservation, and recreational sites. � Conducts research, field studies and evaluations for compliance with regulatory requirements; observes, collects, analyzes, reviews and interprets data, technical reports, and regulatory submissions to make recommendations on project and/or program alternatives. � Prepares technical reports, documentation on consultation efforts, project effect documentation, permits, and Memorandums of Agreement. � Coordinates and negotiates with local, state and federal regulatory agencies to obtain necessary permits or approvals and ensure project delivery of proposed construction related activities that may affect environmental or cultural resources. � Makes recommendations and negotiates mitigation efforts with project managers, regulatory agencies and other project stakeholders; ensures these commitments are met. � Meets with engineering and other project personnel, state agency personnel, project stakeholders and regulatory agencies to resolve resource compliance issues and keep project/programs moving to completion.� � Formulates plans and policies to preserve and enhance the social and natural environment. � May meet with community leaders, special interest groups, resource agencies, the general public, or other affected parties to provide outreach and education on environmental impacts, mitigation, and environmental stewardship using a variety of forums such as seminars, workshops, conferences, newsletters, assessments, and analytical reports. � May review draft environmental or cultural legislation proposals, regulations, or rule changes and provide comments regarding the proposed changes as they relate to the development of projects and/or programs.

    Job Requirements

    JOB REQUIREMENTS for Environmental�Specialist IV Applicants must have education, training and/or experience demonstrating competence in each of the following areas: Possession of a Master’s degree or higher in Environmental Planning, Biology, Environmental Science, Natural Science, Architectural History/Historical Preservation, Archaeology/Anthropology or related field OR a Bachelor’s degree or higher in Environmental Planning, Biology, Environmental Science, Natural Science, Architectural History/Historic Preservation, Archaeology/Anthropology, or related field and a recognized contribution to the field or agency. Five years’ experience in performing environmental specialist work which includes the analysis and assessment of environmental and/or cultural impacts of projects and/or programs. Three years’ experience in collecting, compiling, and analyzing data, and publishing a technical report on the results of an environmental project. Three years’ experience in technical report writing. Three years’ experience in ensuring compliance with environmental laws, rules, regulations, standards, policies and procedures. Two years’ experience in environmental project management which includes planning, developing, implementing, managing and evaluating environmental projects to ensure objectives are met. One year experience serving as a subject matter expert for climate change mitigation policy, programs, and/or development and implementation of climate action plans, strategies, and analyses.

    Additional Posting Information

    The State of Delaware recognizes the value of telework and flexible working schedules. This position is eligible for Telework according to the State of Delaware’s Alternative Work Arrangement Policy. More information will be shared at the time of interview.

    Conditions of Hire

    DNREC does not provide sponsorship for holders of H-1 B Visas. Applicants must be legally authorized to work in the United States. The State of Delaware Executive Branch participates in the Federal E-Verify system where the State will provide the federal government with each new hires Form I-9 information to confirm that you are authorized to work in the U.S. For more information refer to our job seeker resources. As a condition of�hire you must possess a valid driver's license (not suspended, revoked or cancelled, or disqualified from driving).

    Benefits

    To learn more about the comprehensive benefit package please visit our website at https://dhr.delaware.gov/benefits/

    Selection Process

    The application and supplemental questionnaire are evaluated based upon a rating of your education, training and experience as they relate to the job requirements of the position. It is essential that you provide complete and accurate information on your application and the supplemental questionnaire to include dates of employment, job title and job duties. For education and training, list name of educational provider, training course titles and summary of course content. Narrative information supplied in response to the questions must be supported by the information supplied on the application including your employment, education and training history as it relates to the job requirements. Once you have submitted your application on-line, all future correspondence related to your application will be sent via email. Please keep your contact information current. You may also view all correspondence sent to you by the State of Delaware in the “My Applications” tab at StateJobs.Delaware.gov.

    Accommodations

    Accommodations are available for applicants with disabilities in all phases of the application and employment process.� To request an auxiliary aid or service please call (302) 739-5458. TDD users should call the Delaware Relay Service Number 1-800-232-5460 for assistance. The State of Delaware is an Equal Opportunity employer and values a diverse workforce. We strongly encourage and seek out a workforce representative of Delaware including race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression.�

  • 1 Day Ago

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Ophthalmic Technician
  • Omni Eye Specialist Pa
  • Wilmington, DE FULL_TIME
  • ** Regular travel to satellite locations is required ** ESSENTIAL JOB DUTIES: Greets patients and visitors in a prompt, courteous and helpful manner. Obtains patient history and transcribes results in...
  • 1 Month Ago

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Policy Manager
  • Biden for President
  • Wilmington, DE FULL_TIME
  • The policy advisor would support the deputy policy directors to contrast President Biden and Vice President Harris’s policy accomplishments and agenda with the Trump's, including in key states and dem...
  • 1 Day Ago

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Policy Associate
  • Biden for President
  • Wilmington, DE FULL_TIME
  • The Policy Associate will work with the National Policy Director and the Biden for President Policy Team by providing administrative support, project-managing work streams, assisting with material dra...
  • 5 Days Ago

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Medical Administrative Specialist III
  • Goodwill of Delaware and Delaware County
  • Castle, DE FULL_TIME
  • Medical Administrative Specialist III – Your main role is to support the Medical Department at the DMMA As an Administrative Specialist your duties include but are not limited to: Manage Microsoft Out...
  • 21 Days Ago

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Medical Reimbursement Specialist
  • GHR Search
  • Castle, DE FULL_TIME
  • POSITION SUMMARY: To perform this job successfully, and individual must be able to perform the essential functions of this position satisfactorily but are not necessarily limited to the following: Res...
  • 23 Days Ago

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Medical Specialist
  • U.S. Air Force Reserve
  • Position Summary Our hundreds of medical facilities around the world are only as good as the staff who run them. Providi...
  • 4/26/2024 12:00:00 AM

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Inventory Medical Specialist - Materials Services OR
  • Hoag Memorial Hospital Presbyterian
  • ** Inventory Medical Specialist - Materials Services OR** Department: Support Services Status: Full Time Shift: 1st **Pr...
  • 4/26/2024 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...
  • 4/25/2024 12:00:00 AM

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Medical Specialist
  • PSG Global Solutions Careers
  • South San Francisco, CA
  • Apply now and our proprietary system will quickly have you in front of a live recruiter. The Opportunity Description We'...
  • 4/24/2024 12:00:00 AM

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Medical Specialist I (Gastro)-Greenville, SC
  • Regeneron Pharmaceuticals
  • Columbia, SC
  • The Medical Specialist (Sales Representative), Gastroenterology (MS) will report to the District Manager, Gastroenterolo...
  • 4/24/2024 12:00:00 AM

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Medical Specialist 1
  • StateJobsNY
  • Tupper Lake, NY
  • Minimum Qualifications: Open Competitive: Possession of a license and current registration to practice medicine in New Y...
  • 4/23/2024 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...
  • 4/22/2024 12:00:00 AM

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RN-WMG-Endo Medical Specialist-Days
  • Wellstar Medical Specialists
  • Marietta, GA
  • Summary: Ambulatory/Outpatient refers to medical services performed on an outpatient basis, without admission to a hospi...
  • 4/22/2024 12:00:00 AM

Delaware is 96 miles (154 km) long and ranges from 9 miles (14 km) to 35 miles (56 km) across, totaling 1,954 square miles (5,060 km2), making it the second-smallest state in the United States after Rhode Island. Delaware is bounded to the north by Pennsylvania; to the east by the Delaware River, Delaware Bay, New Jersey and the Atlantic Ocean; and to the west and south by Maryland. Small portions of Delaware are also situated on the eastern side of the Delaware River sharing land boundaries with New Jersey. The state of Delaware, together with the Eastern Shore counties of Maryland and two co...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$90,786 to $110,820

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