Medical Policy Specialist jobs in New Hampshire

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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SYSTEMS ANALYST, DATA POLICY & PRIVACY SPECIALIST
  • New Hampshire Hospital
  • Concord, NH FULL_TIME
  • Salary: 33.470-43.390 :USD

    State of New Hampshire Job Posting

    Department of Health and Human Services

    Division of Public Health Services

    Concord, NH- Hazen Drive

    SYSTEMS ANALYST, DATA POLICY & PRIVACY SPECIALIST

    15-1210 COMP-INFO ANALYSTS-3

    #9T3300

    $33.47-$43.39 Hourly


    YOUR EXPERIENCE COUNTS - Under a recent change to the rules, an applicant's relevant experience now counts towards formal education degrees referenced in the posting See Per 405.1.

    18 Months of additional relevant experience = Associate's degree

    36 Months of additional relevant experience = Bachelor's degree

    54 Months of additional relevant experience = Master's degree

    *See total compensation information at the bottom of announcement.

    The State of New Hampshire, Department of Health and Human Services, Division of Public Health Services has a full time vacancy for Systems Analyst, Data Policy and Privacy Specialist. This is a grant-funded position and is subject to renew every two years.

    SUMMARY:

    To analyze and formulate information and data system requirements to increase the efficiency of agency business operations that depend on health data and information, and to ensure compliance with regulations and internal policies relating to the protection of sensitive and confidential data, as well as evaluate the life cycle of data systems built for the collection, dissemination, and analysis of health statistics.

    RESPONSIBILITIES:

    Meets with the state agency representatives, including epidemiologists, data managers, privacy officer, communications director, and information services lead to ensure needs and requirements to support data confidentiality, integrity through planning, analysis, development, maintenance, and dissemination of the public health data systems.

    Evaluates the lifecycle of business data including collection, storage, transfer retention and disposal of information and provides subject matter expertise for data privacy requirements and best practices to ensure compliance with regulations and internal policies relating to the protection of sensitive and confidential data.

    Assists programs to create appropriate privacy confidentiality consent forms, authorization forms, and information notices and materials reflecting current organization and privacy practices and requirements for the public health data and information activities.

    Develops and prepares data use and sharing agreements for data release and requests. Collaborates with the programs in the division in charge to respond to data and information requests for accessing to non-public, restrict or confidential data.

    Develops and updates public health data and statistical suppression standards and guidance related to data collection, analysis, dissemination and use to promote good professional practice among programs involved in assessment activities within the division, to provide reliable statistics and protect data privacy and confidentiality.

    Participates in meetings and discussion with privacy officer, information service lead, program managers and other stakeholders internal or external to evaluate and implement data privacy and security requirements that align with the department regulatory compliance requirements and policy.

    Applies knowledge of the concepts, principles, theories, methods, and tools associated with protecting and improving the health of people and their communities, including promoting healthy lifestyles, researching disease and injury prevention, and detecting, preventing, and promoting public health data and information.

    MINIMUM QUALIFICATIONS:

    Education: Bachelor's degree from a recognized college or university, preferably with a major in management information services or systems, epidemiology, public policy, statistics, computer information systems, communication, or computer science. Each additional year of specialized formal education may be substituted for one year of required work experience.

    Experience: Six years' experience in systems analysis with a broad-based knowledge of business environments, preferably in a field or occupation related to information security, data policy, software development, software support, or software maintenance, three years of which shall have included the direct involvement in data management and governance. Each additional year of approved work experience may be substituted for one year of required formal education.

    License/Certification: None required

    RECOMMENDED WORK TRAITS: Knowledge of business operations and procedures relevant to DHHS including standard principles and methods of epidemiology and related health statistics for analyses and interpretation of data. Knowledge of public health principles related to epidemiology and surveillance. Skills in using MS Office programs, statistical software (e.g., SAS, STATA, R, SPSS). Ability to analyze agency business needs. Ability to make independent decisions, manage competing priorities and tasks, and operate in a changing public health environment. Ability to communicate clearly and concisely. Ability to work collaboratively within a team and with other partners providing excellent customer service.

    DISCLAIMER STATEMENT: The supplemental job description lists the essential functions of the position and is not intended to include every job duty and responsibility specific to the position. An employee may be required to perform other related duties not listed on the supplemental job description provided that such duties are characteristic of that classification.

    For further information please contact Chiahui Chawla, Administrator IV, Chiahui.S.Chawla@DHHS.NH.GOV, 603-271-4933.


    *TOTAL COMPENSATION INFORMATION

    The State of NH total compensation package features an outstanding set of employee benefits, including:

    HMO or POS Medical and Prescription Drug Benefits:

    The actual value of State-paid health benefits is based on the employee's union status, and employee per pay period health benefit contributions will vary depending on the type of plan selected.

    See this link for details on State-paid health benefits: https://das.nh.gov/hr/benefits.html

    Value of State's share of Employee's Retirement: 13.85% of pay

    Other Benefits:

    o Dental Plan at minimal cost for employees and their families ($500-$1800 value)

    o Flexible Spending healthcare and childcare reimbursement accounts

    o State defined benefit retirement plan and Deferred Compensation 457(b) plan

    o Work/life balance flexible schedules, paid holidays and generous leave plan

    o $50,000 state-paid life insurance plus additional low cost group life insurance

    o Incentive-based Wellness Program (ability to earn up to $500)

    Total Compensation Statement Worksheet:

    https://das.nh.gov/documents/hr/JobSearch/FINAL_TOTAL_COMP_STATEMENT_ISSUE.xlsx

    Want the specifics? Explore the Benefits of State Employment on our website:

    https://das.nh.gov/hr/documents/BenefitBrochure.pdf

    https://das.nh.gov/hr/index.aspx

    EOE

    TDD Access: Relay NH 1-800-735-2964

  • 7 Days Ago

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Senior Platform Policy Specialist, Minor Safety and Exploitative Content
  • Discord - Netherlands
  • Amsterdam, NH FULL_TIME
  • Discord is about giving people the power to create space to find belonging in their lives. We want to make it easier for you to talk regularly with the people you care about. We want you to build genu...
  • 5 Days Ago

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Medical Specialist Advisor (For SkillBridge Applicants Only)
  • Pirouette Medical
  • Portsmouth, NH INTERN
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  • 1 Month Ago

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Lawn Specialist
  • TruGreen - Lawn Specialist - Londonderry, NH
  • Hooksett, NH FULL_TIME
  • TruGreen is Hiring Residential Lawn SpecialistsStart at $20 per Hour - Comprehensive BenefitsAt TruGreen, we are committed to our customers, our teams, our values, and the science of lawn care. A care...
  • 3 Days Ago

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Medical specialist
  • US Army
  • Keene, NH FULL_TIME
  • ELIGIBLE FOR UP TO A $15K SIGNING BONUS. TALK TO YOUR RECRUITER FOR DETAILS.* ABOUT THIS JOB THIS POSITION REQUIRES AN ENLISTMENT IN THE U.S. ARMY OR ARMY RESERVE As a Combat Medic Specialist, you'll ...
  • 4 Days Ago

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Retail Merchandiser (PT)
  • Apollo Retail Specialist
  • Concord, NH 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...
  • 20 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

New Hampshire is part of the six-state New England region. It is bounded by Quebec, Canada, to the north and northwest; Maine and the Atlantic Ocean to the east; Massachusetts to the south; and Vermont to the west. New Hampshire's major regions are the Great North Woods, the White Mountains, the Lakes Region, the Seacoast, the Merrimack Valley, the Monadnock Region, and the Dartmouth-Lake Sunapee area. New Hampshire has the shortest ocean coastline of any U.S. coastal state, with a length of 18 miles (29 km), sometimes measured as only 13 miles (21 km). New Hampshire was home to the rock forma...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Medical Policy Specialist jobs
$90,432 to $110,387

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