Medical Policy Specialist jobs in Hawaii

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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Information Technology Specialist (Policy and Planning)
  • U.S. Army Cyber Command
  • Schofield Barracks, HI FULL_TIME
  • Duties

    • Provide policy, direction, and technical guidance for the analysis, coordination, planning, and implementation of new and emerging technologies and new and improved information systems to meet the business requirements of our customer organizations.
    • Apply a broad knowledge of IT principles, concepts, and methods in order to develop and maintain overall functional and systems requirements, specifications and strategic plans.
    • Prepare required inputs to the budgeting and investment planning processes.
    • Assess policy needs and develops policies to govern IT activities; provides policy guidance to IT management, staff, and customers; defines current and future business environments; conducts audits of IT programs and policies.
    • Identify existing functional requirements and develops specific recommendations for systems improvement/automation.
    • Coordinate and recommend software and equipment requirements/specifications as required for system/program applications, development, or enhancements.
    • Lead and/or participate in discussion, meetings, conferences, committees or special IT projects.

    Requirements

    Conditions of Employment

    • Appointment may be subject to a suitability or fitness determination, as determined by a completed background investigation.
    • This position requires the incumbent be able to obtain and maintain a determination of eligibility for a Secret security clearance or access for the duration of employment.
    • This position requires the incumbent to obtain and maintain the appropriate Information Assurance certification in accordance with DoD 8570.01-M, Information Assurance Workforce Improvement Program, within 6 months of entry onto duty.
    • This is a non-TDY position, but local travel will be required in conjunction with this position.
    • The employee may be required to work overtime.
    • The employee may be required to work other than normal duty hours, which may include evenings, weekends, and/or holidays.
    • Call back and emergency duty are regular requirements of this position.
    • Must possess a valid motor vehicle driver?s license.

    Qualifications

    Who May Apply: US Citizens

    In order to qualify, you must meet the experience requirements described below. Experience refers to paid and unpaid experience, including volunteer work done through National Service programs (e.g., Peace Corps, AmeriCorps) and other organizations (e.g., professional; philanthropic; religious; spiritual; community; student; social). You will receive credit for all qualifying experience, including volunteer experience. Your resume must clearly describe your relevant experience; if qualifying based on education, your transcripts will be required as part of your application. Additional information about transcripts is in this document.

    Basic Requirement for Information Technology Specialist (Policy and Planning):

    Specialized and Other Experience: One year of specialized experience which includes assessing Information Technology (IT) concepts, programs, and plans to provide guidance for staff and customers; identifying opportunities or deficiencies for improvement of IT systems; and assisting in the development of solutions to system interface problems. This definition of specialized experience is typical of work performed at the next lower grade/level position in the federal service (GS-11).

    The specialized experience must include, or be supplemented by, information technology related experience (paid or unpaid experience and/or completion of specific, intensive training, as appropriate) which demonstrates each of the four competencies, as defined:

    (1) Attention to Detail - Is thorough when performing work and conscientious about attending to detail. Examples of IT-related experience demonstrating this competency include: completing thorough and accurate work independently, even in the most difficult or stressful situations; occasionally reviewing work completed by others.

    (2) Customer Service - Works with clients and customers (that is, any individuals who use or receive the services or products that your work unit produces, including the general public, individuals who work in the agency, other agencies, or organizations outside the Government) to assess their needs, provide information or assistance, resolve their problems, or satisfy their expectations; knows about available products and services; is committed to providing quality products and services. Examples of IT-related experience demonstrating this competency include: resolving routine and non-routine problems, questions, or complaints; developing and maintaining strong, mutually supportive working relationships with customers; conducting evaluation of support to determine quality of services and customer satisfaction, and recommending procedural changes based on customer need or changes in policy and/or regulation.

    (3) Oral Communication - Expresses information (for example, ideas or facts) to individuals or groups effectively, taking into account the audience and nature of the information (for example, technical, sensitive, controversial); makes clear and convincing oral presentations; listens to others, attends to nonverbal cues, and responds appropriately. Examples of IT-related experience demonstrating this competency include: convincingly conveying complex information to customers; presenting thoughts that are well-organized and demonstrating confidence in the facts and ideas; adjusting style when working with individuals with different levels of understanding; using various methods to explain and convey information.

    (4) Problem Solving - Identifies problems; determines accuracy and relevance of information; uses sound judgment to generate and evaluate alternatives, and to make recommendations. Examples of IT-related experience demonstrating this competency include: solving complex or sensitive problems by developing and proposing strategic alternatives; identifying possible conflicts and shared benefits; helping team anticipate problems and identifying and evaluating potential sources of information; providing feedback and coaching to others to help solve problems; engaging appropriate stakeholders when developing solutions in order to understand and incorporate multiple perspectives and needs; evaluating the effectiveness of decisions and adjusting future decisions as appropriate.
    Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone-no substitution of education for experience is permitted.

    Some federal jobs allow you to substitute your education for the required experience in order to qualify. For this job, you must meet the qualification requirement using experience alone-no substitution of education for experience is permitted.

    Education

    This job does not have an education qualification requirement.

    Additional information

    • Male applicants born after December 31, 1959, must complete a Pre-Employment Certification Statement for Selective Service Registration.
    • You will be required to provide proof of U.S. Citizenship.
    • Two year trial/probationary period may be required.
    • Direct Deposit of Pay is required.
    • Selection is subject to restrictions resulting from Department of Defense referral system for displaced employees.
    • If you have retired from federal service and you are interested in employment as a reemployed annuitant, see the information in the Reemployed Annuitant information sheet.
    • This is a Career Program (CP) 34-Information Technology/Cyber Management Position
    • Multiple positions may be filled from this announcement.
    • Salary includes applicable locality pay or Local Market Supplement.
    • When you perform a Civilian Permanent Change of Station (PCS) with the government, the Internal Revenue Service (IRS) considers the majority of your entitlements to be taxable. Visit https://www.dfas.mil/civilianemployees/civrelo/Civilian-Moving-Expenses-Tax-Deduction/ for more information.
    • If you are unable to apply online or need to fax a document you do not have in electronic form, view the following link for information regarding an Alternate Application.
    • Permanent Change of Station (PCS) allowances may be authorized, subject to the provisions of the Joint Travel Regulations and an agency determination that a PCS move is in the Government Interest.
    • This position MAY be eligible for situational telework only, including emergency and OPM prescribed "Unscheduled Telework".
    • Due to COVID-19, the agency is currently in an expanded telework posture. If selected, you may be expected to temporarily telework, even if your home is located outside the local commuting area. Once employees are permitted to return to the office, you will be expected to report to the duty station listed on this announcement within a designated time frame identified by the organization. At that time, you may be eligible to request to continue to telework one or more days a pay period depending upon the terms of the agency's telework policy.
    • Information may be requested regarding the vaccination status of selectees for the purposes of implementing workplace safety protocols. For more information, visit https://www.saferfederalworkforce.gov/faq/vaccinations/.

    • Benefits

      A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

      Review our benefits

      Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

    How You Will Be Evaluated

    You will be evaluated for this job based on how well you meet the qualifications above.

    Once the announcement has closed, a review of your application package (resume, supporting documents, and responses to the questionnaire) will be used to determine whether you meet the qualification requirements listed on this announcement.

    If, after reviewing your résumé and/or supporting documentation, a determination is made that you have inflated your qualifications and/or experience, you may lose consideration for this position. Please follow all instructions carefully when applying, errors or omissions may affect your eligibility.

    You should list any relevant performance appraisals and incentive awards in your resume as that information may be taken into consideration during the selection process. If selected, you may be required to provide supporting documentation.

    Veterans and Military Spouses will be considered along with all other candidates.

    • Benefits

      A career with the U.S. government provides employees with a comprehensive benefits package. As a federal employee, you and your family will have access to a range of benefits that are designed to make your federal career very rewarding. Opens in a new windowLearn more about federal benefits.

      Review our benefits

      Eligibility for benefits depends on the type of position you hold and whether your position is full-time, part-time or intermittent. Contact the hiring agency for more information on the specific benefits offered.

    • Required Documents

      As a new or existing federal employee, you and your family may have access to a range of benefits. Your benefits depend on the type of position you have - whether you're a permanent, part-time, temporary or an intermittent employee. You may be eligible for the following benefits, however, check with your agency to make sure you're eligible under their policies.

      The documents you are required to submit vary based on whether or not you are eligible for preference in federal employment. A complete description of preference categories and the associated required documents is in the Applicant Checklist (External).

      As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply. If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.

      1. Your resume:

      • Your resume may be submitted in any format and must support the specialized experience described in this announcement.
      • If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations and you may not be considered for this vacancy.
      • For qualifications determinations your resume must contain hours worked per week and the dates of employment (i.e., HRS per week and month/year to month/year or month/year to present). If your resume does not contain this information, your application may be marked as incomplete and you may not receive consideration for this position.
      • For additional information see: What to include in your resume.
      2. Other supporting documents:
      • Cover Letter, optional
      • Most recent Performance Appraisal, if applicable
      NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.
    • How to Apply

      To apply for this position, you must complete the online questionnaire and submit the documentation specified in the Required Documents section above.

      The complete application package must be submitted by 11:59 PM (EST) on 10/12/2022 to receive consideration

      • To begin, click Apply to access the online application. You will need to be logged into your USAJOBS account to apply. If you do not have a USAJOBS account, you will need to create one before beginning the application (https://apply.usastaffing.gov/ViewQuestionnaire/11662316).
      • Follow the prompts to select your résumé and/or other supporting documents to be included with your application package. You will have the opportunity to upload additional documents to include in your application before it is submitted. Your uploaded documents may take several hours to clear the virus scan process.
      • After acknowledging you have reviewed your application package, complete the Include Personal Information section as you deem appropriate and click to continue with the application process.
      • You will be taken to the online application which you must complete in order to apply for the position. Complete the online application, verify the required documentation is included with your application package, and submit the application. You must re-select your resume and/or other documents from your USAJOBS account or your application will be incomplete.
      • It is your responsibility to verify that your application package (resume, supporting documents, and responses to the questionnaire) is complete, accurate, and submitted by the closing date. Uploaded documents may take up to one hour to clear the virus scan.
      • Additional information on how to complete the online application process and submit your online application may be found on the USA Staffing Applicant Resource Center.
      To verify the status of your application, log into your USAJOBS account (https://my.usajobs.gov/Account/Login), all of your applications will appear on the Welcome screen. The Application Status will appear along with the date your application was last updated. For information on what each Application Status means, visit: https://www.usajobs.gov/Help/how-to/application/status/.

      Agency contact information

      Army Applicant Help Desk

      Website

      https://portal.chra.army.mil/hr_public?id=app_inq

      Address

      EJ-APF-W4NHAA NETCOM
      DO NOT MAIL
      Fort Huachuca, AZ 85613
      US

      Next steps

      If you provided an email address, you will receive an email message acknowledging receipt of your application. Your application package will be used to determine your eligibility, qualifications, and quality ranking (as applicable) for this position. If you are determined to be ineligible or not qualified, your application will receive no further consideration.

    • Fair and Transparent

      The Federal hiring process is set up to be fair and transparent. Please read the following guidance.

      • Equal Employment Opportunity (EEO) Policy
      • Reasonable accommodation policy
      • Financial suitability
      • Selective Service
      • New employee probationary period
      • Signature and false statements
      • Privacy Act
      • Social security number request

    Required Documents

    The documents you are required to submit vary based on whether or not you are eligible for preference in federal employment. A complete description of preference categories and the associated required documents is in the Applicant Checklist (External).

    As described above, your complete application includes your resume, your responses to the online questionnaire, and documents which prove your eligibility to apply. If you fail to provide these documents, you will be marked as having an incomplete application package and you will not be considered any further.

    1. Your resume:

    • Your resume may be submitted in any format and must support the specialized experience described in this announcement.
    • If your resume includes a photograph or other inappropriate material or content, it will not be used to make eligibility and qualification determinations and you may not be considered for this vacancy.
    • For qualifications determinations your resume must contain hours worked per week and the dates of employment (i.e., HRS per week and month/year to month/year or month/year to present). If your resume does not contain this information, your application may be marked as incomplete and you may not receive consideration for this position.
    • For additional information see: What to include in your resume.
    2. Other supporting documents:
    • Cover Letter, optional
    • Most recent Performance Appraisal, if applicable
    NOTE: Documents submitted as part of the application package, to include supplemental documents, may be shared beyond the Human Resources Office. Some supplemental documents such as military orders and marriage certificates may contain personal information for someone other than you. You may sanitize these documents to remove another person's personal information before you submit your application. You may be asked to provide an un-sanitized version of the documents if you are selected to confirm your eligibility.


    Help

    This job is open to

    • The public

      U.S. Citizens, Nationals or those who owe allegiance to the U.S.

    Clarification from the agency

    See "Who May Apply" in the "Qualifications" section for more information on who is eligible to apply for this position.

  • 1 Month Ago

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IT Cybersecurity Specialist (Information Security/Policy Plan)
  • US Defense POW/MIA Accounting Agency
  • Hickam AFB, HI FULL_TIME
  • Duties This is a Direct Hire Public Notice, under this recruitment, applications will be accepted for each location and/or installation identified in this Public Notice and selections are made for vac...
  • 1 Day Ago

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Gift Card Merchandiser (Supplemental Position) 2023-32047
  • Apollo Retail Specialist
  • Lihue, HI PART_TIME
  • As a merchandiser, you’ll take on project-based work to ensure products and displays are visually appealing to attract and engage shoppers, build strong relationships with store managers, ensure the r...
  • 7 Days Ago

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Gift Card Merchandiser (Supplemental Position) 2023-32047
  • Apollo Retail Specialist
  • Lihue, HI PART_TIME
  • As a merchandiser, you’ll take on project-based work to ensure products and displays are visually appealing to attract and engage shoppers, build strong relationships with store managers, ensure the r...
  • 7 Days Ago

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Assembly Technician (2023-33297)
  • Apollo Retail Specialist
  • Honolulu, HI PART_TIME
  • Can’t stand being stuck behind a desk? Like working solo? Good with your hands? We have the perfect job for you as a Service Technician! Go store to store and work independently to keep the furniture ...
  • 11 Days Ago

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Assembly Technician
  • Apollo Retail Specialist
  • Kona, HI PART_TIME
  • Can’t stand being stuck behind a desk? Like working solo? Good with your hands? We have the perfect job for you as a Service Technician! Go store to store and work independently to keep the furniture ...
  • 15 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

Hawaii (/həˈwaɪi/ (listen) hə-WY-ee; Hawaiian: Hawaiʻi [həˈvɐjʔi]) is the 50th and most recent state to have joined the United States, having received statehood on August 21, 1959. Hawaii is the only U.S. state located in Oceania, the only U.S. state located outside North America, and the only one composed entirely of islands. It is the northernmost island group in Polynesia, occupying most of an archipelago in the central Pacific Ocean. The state encompasses nearly the entire volcanic Hawaiian archipelago, which comprises hundreds of islands spread over 1,500 miles (2,400 km). At the southea...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$93,470 to $114,095

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