Medical Policy Specialist jobs in Kansas

Company: Community Care Network of Kansas
Job Title: Healthcare Policy Specialist
Job Classification: Full-Time, Exempt
Supervisor: Policy Director
Salary Range: Negotiable based on experience
Schedule: Monday through Friday, 8:00 am to 5:00pm (or similar schedule)
Location: Topeka, KS

Who We Are:
Community Care Network of Kansas (Community Care) strives to ensure all Kansans have access to quality, community‐based healthcare close to home. We are a statewide association made up of a network of community clinics, all dedicated to providing the best medical, dental and behavioral care to Kansans.

Together, we are leaders in healthcare training, technical assistance, and public policy. We collaborate with healthcare associations, providers, foundations and individuals to educate and advocate for equitable access to high‐quality care for all. We believe healthy Kansans build strong and vibrant communities, which strengthens the overall quality of life in our great state.

Primary Accountabilities:
The Healthcare Policy Specialist will work with a team of Community Care staff, the Board of Directors, the Legislative Committee, and member clinics to help align state and federal policy with member clinic goals and outcomes. This position has a specific focus on legislative, regulatory, and/or administrative financial or workforce policy that increases or hinders access to care.

Major Responsibilities:

• Serves as subject matter expert for healthcare reimbursement and financing policy and regulations, including those specific to federally qualified health centers.
• Establishes and maintains partnerships, including but not limited to the Medicaid agency, KDHE, KDADS, state health professional licensing agencies, managed care organizations and commercial insurers.
• Remains current in Medicaid, Medicare and other healthcare policy and their impact on member clinics.
• Works with other members of the policy team to analyze potential Federal and state legislative, regulatory, licensing or payment policy changes on member clinics to determine their priority and urgency levels. Collects and uses data to demonstrate the impact of current policy on member clinics and the need for change. Provides technical assistance and problem‐solving support to member clinics as they experience payment, credentialing, licensing, or other challenges with payers, state agencies, and state licensing boards.
• Supports Community Care training, work groups, and grant activities focused on finance and reimbursement policy and its implications for value‐based reimbursement, alternative payment methods or other payment change.
• Coordinates efforts to build advocacy capacity of member clinics and stakeholders through training, workgroup participation, and regular communications with member clinics. Works with other policy staff to ensure that advocacy efforts throughout the network are aligned.
• Performs additional duties as assigned..

Qualifications:

• Bachelor’s degree in business, healthcare finance, healthcare policy, public administration, or similar field of study; Master’s degree preferred.
• Three to five (3‐5) years’ of work experience in related field.
• Unrestricted Driver’s License required.
• Experience in Medicaid, Medicare, managed care, commercial insurance, or other healthcare finance or policy.
• Working knowledge of Medicare and Medicaid payment policies, state licensing regulations, and the Kansas commercial health insurance environment.
• Familiarity with Kansas legislative processes.
• Ability to promote a professional and positive appearance and work environment.
• Ability to make sound, independent decisions in a fast‐paced environment.
• Ability to communicate complex and technical information in a clear and concise manner, both verbally and written.
• Strong interpersonal, organizational, written and verbal communication skills required.
• Creative thinking and problem‐solving skills; willingness to seek input regularly for process improvement.
• Passion and commitment to improving health and social justice.
• Ability to work effectively with multiple individuals and manage several projects at once with minimal supervision.
• Demonstrated poise, tact and diplomacy with the ability to handle sensitive and confidential information and situations.

Physical Demands:

• Regularly maintain stationary position with regular need to relocate to attend meetings internally and externally.
• Ability to read computer screens and operate computer peripherals for an extended period of time, or the ability to discern electronic information through reasonably available accommodations.
• Regularly communicate with staff, members and stakeholders in writing, video conferencing and inperson meetings.
• Ability to lift or have the ability to utilize reasonably available resources to maneuver, up to fifty (50) pounds.
• Regularly required to speak and hear, sit, stand, bend, stoop, kneel and walk.
• Ability to travel as needed within the State of Kansas and nationally.

Work Environment:

• Professional and deadline-oriented environment in an office setting with regulated temperatures and moderate noise level.

Additional Duties: Additional duties and responsibilities may be added to this job description at any time. The job description does not state or imply that these are the only activities to be performed by the employee(s) holding this position. Employees are required to follow any other job-related instructions and to perform any other job-related responsibilities are requested by their supervisor.