Talent.com
Health Plan Policy Specialist
Health Plan Policy SpecialistUniversity of Utah • Murray, Utah, United States
Health Plan Policy Specialist

Health Plan Policy Specialist

University of Utah • Murray, Utah, United States
[job_card.30_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Overview

: University of Utah Health is an integrated academic healthcare system with five hospitals including a level 1 trauma center, eleven community health centers, over 1,600 providers, and a health plan serving over 200,000 members. University of Utah Health is nationally ranked and recognized for our academic research, quality standards and overall patient experience. In addition to our clinical delivery system, we have a School of Medicine, School of Dentistry, College of Nursing, College of Pharmacy, and College of Health providing education and training for over 1,250 providers annually. We have over 2 million patient visits annually and research grants exceeding $350 million. University of Utah Hospitals and Clinics represents our clinical operations for the larger health system.

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education. Success in this mission requires a culture of collaboration, excellence, leadership, and respect. University of Utah Health seeks staff that are committed to the values of compassion, collaboration, innovation, responsibility, integrity, quality and trust that are integral to our mission. EO/AA

Responsibilities
  • Research and draft medical, administrative, and reimbursement policies based on clinical evidence, regulatory requirements, and industry standards.
  • Ensure policies align with company guidelines, NCQA standards, and applicable laws.
  • Collaborate with internal stakeholders to review and approve policies.
  • Monitor legislative and regulatory changes impacting health plan policies.
  • Support governance committees for policy review and approval.
  • Maintain accurate documentation and version control of all policies.
  • Provide subject matter expertise for policy interpretation and application.
  • Assist in remediation of gaps in existing processes related to policy compliance.
  • Respond to inquiries regarding policy requirements.

Knowledge / Skills / Abilities

  • Strong analytical and technical writing skills.
  • Knowledge of healthcare economics, reimbursement practices, and regulatory compliance.
  • Proficiency in Microsoft Office and policy management tools.
Qualifications

Required

  • Bachelor's degree in a related field or equivalency.
  • Three years of health plans, policy development & maintenance, healthcare, and/or compliance.
  • Demonstrated intermediate skills in internet database searches.
Qualifications (Preferred)
  • Bachelor's degree in a clinical science (. nursing, medical technology), or health related field, or the equivalency.
  • Certified professional coder.

Working Conditions and Physical Demands

Employee must be able to meet the following requirements with or without an accommodation.

  • This is a position that may exert up to 10 pounds and may lift, carry, push, pull or otherwise move objects. This position may involve standing or sitting for long periods of time and is not exposed to adverse environmental conditions.
Physical Requirements Carrying, Lifting, Listening, Pulling and/or Pushing, Sitting, Speaking, Standing

Multi-lingual Candidates Welcomed

Interested in this opportunity?
Socialize this job opportunity to a friend, colleague, or family member:



[job_alerts.create_a_job]

Health Plan Policy Specialist • Murray, Utah, United States

[internal_linking.similar_jobs]

Medical Director - Behavioral Health

CommonSpirit HealthWest Valley City, UT, US
[job_card.full_time]

Job Summary and Responsibilities.As a physician-facing organization, our Physician Group is passionate about high-value, top quality care made accessible in every community we serve.Our resources i...[internal_linking.show_more]

 • [job_card.promoted]

Strategic Director, Financial Aid & Pathways

Western Governors UniversitySalt Lake City, UT, United States
[job_card.full_time]

A prominent online university in Salt Lake City is seeking a Director of Financial Aid Strategy and Pathways to lead strategic initiatives related to financial aid delivery and serve as the liaison...[internal_linking.show_more]

 • [job_card.promoted]

Retirement Plan Operations Specialist

Guidant FinancialSalt Lake City, UT, US
[filters.remote]
[job_card.full_time]
[filters_job_card.quick_apply]

This is a fantastic opportunity to work from the comfort of your own home! We are excited to offer a fully remote position with a reputable and thriving company.Currently, we are recruiting in sele...[internal_linking.show_more]

Remote Financial Planner - AI Trainer ($50-$60 per hour)

Data AnnotationBluffdale, Utah
[filters.remote]
[job_card.full_time] +1

DataAnnotation is committed to creating high-quality AI.Join our team to help train the next generation of AI while enjoying the flexibility of remote work and the freedom to set your own schedule....[internal_linking.show_more]

 • [job_card.promoted]

Temporary Immunization Office Specialist - Health Department

Salt Lake County (UT)West Valley City, UT, United States
[job_card.full_time]

Job Description JOB SUMMARY Provides customer service and office/program support.Serves as the initial contact for customers, both in person and over-the-phone, for Division related information.MIN...[internal_linking.show_more]

 • [job_card.promoted]

Child Life Specialist

University of UtahSalt Lake City, UT, United States
[job_card.full_time]

As a patient-focused organization, University of Utah Health exists to enhance the health and well-being of people through patient care, research and education.Success in this mission requires a cu...[internal_linking.show_more]

 • [job_card.promoted]

Safety & Occupational Health Specialist

VETERANS HEALTH ADMINISTRATIONSalt Lake City, UT, United States
[job_card.full_time] +2

The position is in the Department of Veterans Affairs (VA), Veterans Health Administration (VHA), at the VA Salt Lake City Health Care System (VASLCHCS) in the Occupational Safety and Health Servic...[internal_linking.show_more]

 • [job_card.promoted]

Healthcare Solutions Program Manager

Brady CorporationSalt Lake City, UT, United States
[job_card.full_time]

The HC Solutions Program Manager is responsible for the design, automation, and execution of PDC's premier customer conversion and retention tool.This role sits at the intersection of Sales, Data A...[internal_linking.show_more]

 • [job_card.promoted]

CX Strategy & Insights Analyst

CaptionCall by SorensonSalt Lake City, UT, United States
[job_card.full_time]

CX Strategy & Insights Analyst.Come be a part of our mission and make a meaningful and positive impact with the industry leading provider of language services for the Deaf and hard-of-hearing!.Paid...[internal_linking.show_more]

 • [job_card.promoted]

Senior Specialist, Program Scheduler

L3Harris TechnologiesBountiful, Utah, US
[job_card.full_time]

L3Harris is looking for an experienced Program Planner/Scheduler who will be part of the Program Planning and Scheduling Department supporting various programs.Want to make an application Make sure...[internal_linking.show_more]

 • [job_card.promoted]

CX Strategy & Insights Analyst

Sorenson CommunicationsSalt Lake City, UT, United States
[job_card.full_time]

CX Strategy & Insights Analyst.Come be a part of our mission and make a meaningful and positive impact with the industry leading provider of language services for the Deaf and hard-of-hearing!.Paid...[internal_linking.show_more]

 • [job_card.promoted]

Epic EHR Subject Matter Expert (Healthcare CX & Contact Center Transformation)

Allshore TalentSalt Lake City, UT, US
[job_card.part_time]

Contract, Advisory/ Consultant (Part-time).This engagement focuses on aligning CX strategy with clinical systems, ensuring seamless integration between contact center platforms, AI solutions, and t...[internal_linking.show_more]

Interventional Cardiology in Salt Lake City Metro

HealthEcareers - ClientFARMINGTON, UT, USA
[job_card.full_time]

Job Description & Requirements.Interventional Cardiology in Salt Lake City Metro.StartDate: ASAP Pay Rate: $550000.A private, 6-member Cardiology group has served the greater Salt Lake City area fo...[internal_linking.show_more]

 • [job_card.promoted]

Family Peer Support Specialist - Children, Youth, and Families Mental Health

Davis Behavioral HealthLayton, UT, United States
[job_card.part_time] +1

Davis Behavioral Health is seeking a full-time.Family Peer Support Specialist (FPSS).Children, Youth, and Families Mental Health team.The Family Peer Support Specialist (FPSS) works closely with fa...[internal_linking.show_more]

 • [job_card.promoted]

Structures Equipment Specialist Support Senior F-16 WAM (Secret) - 84

CredenceHill Air Force Base, Utah, US
[job_card.full_time]

Overview At Credence, we support our clients’ mission-critical needs, powered by technology.We provide cutting-edge solutions, including AI/ML, enterprise modernization, and advanced intelligence c...[internal_linking.show_more]

 • [job_card.promoted]

Financial Planning & Analysis Specialist

Potawatomi Federal SolutionsClearfield, UT, United States
[job_card.full_time]

Position Title: Financial Planning & Analysis Specialist.Position Duration: Current - 7/1/2026.Clearance: ***Active Secret clearance required***.Command Cyber Solutions is seeking a highly skilled ...[internal_linking.show_more]

 • [job_card.promoted]

Enrollment Specialist (Healthcare)

Satori DigitalSalt Lake City, UT, US
[job_card.full_time] +1
[filters_job_card.quick_apply]

Our client is on a mission to transform the future of caregiving by providing critical support to families caring for loved ones with dementia and other conditions.With strong traction and rapid gr...[internal_linking.show_more]

68G Patient Administration Specialist

Army National GuardBluffdale, UT, USA
[job_card.full_time] +1

It takes a highly organized and efficient professional to manage day-to-day operations in military medical facilities.As a Patient Administration Specialist for the Army National Guard, you will su...[internal_linking.show_more]