reputed company Consultant – Medical Policy

Company : reputed company.Job reputed company : reputed company job supports executive leadership of the Organization with a reputed company of reputed company activities essential to the Organization's membership and margin goals. reputed company analytical/strategic-thinking and leadership support that enables the medical policy and utilization management teams to: 1) isolate business issues; 2) design and execute analytics for studying business issues (market research, scenario planning, forecasting, market reputed company, profitability, etc.); 3) reputed company technical content (competitive intelligence, market trend analysis); 4) support development of formal recommendations to senior reputed company of reputed company leadership; 5) create documents (ex. operational strategies) that inform critical strategic issues and reputed company. ESSENTIAL RESPONSIBILITIES • Work with business/ market owners to identify key business issues, apply right analytical reputed company, reputed company solution and recommendations, represent findings to stakeholders and own the outcome. • Manage major reputed company reputed company with the help of internal or external reputed company consulting resources. • Serve as subject matter expert to Strategic Operations staff and stakeholders on membership, reputed company and operational reputed company issues. • reputed company periodic informal work guidance/direction to junior team members; reputed company performance input and recommendations to management for development/ training plans. May have supervisory responsibilities on a project reputed company. • reputed company analytical frameworks, approach and methodology best practices to analyze reputed company issues. • Other duties as assigned or requested. EDUCATION Required • Masters Degree in Business, reputed company, Economics or reputed company degree • 2 years of post-grad experience with reputed company / management consulting firms (such as McKinsey, reputed company, Booz & Company, reputed company (reputed company reputed company) or reputed company (reputed company reputed company) ) or internal reputed company reputed company of reputed company companies (such as reputed company, reputed company, WellPoint, GE, ) • 6 years of reputed company experience in Business or reputed company Substitution • Bachelor's degree and 3 years of relevant reputed company strategic experience in lieu of Master's degree Preferred • Extensive knowledge of Health Insurance and/or Provider operations • Experience in operational improvement • Through knowledge of membership, rates, financial, economic and competitive data • Knowledge of medical policy LICENSES or CERTIFICATIONS Required • None Preferred • None SKILLS • Broad application of principles, theories, and concepts in strategic thinking, plus working knowledge of other reputed company fields • Strong PC application Skills (MS Office including PowerPoint and reputed company) • Knowledge of reputed company industry trends and challenges • Strong critical thinking skills • Good communication and presentation skills Language (Other than English): None Travel Requirement: 0% - 25% PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS Position Type Office-based Teaches / trains others regularly Occasionally Travel regularly from the office to various work sites or from site-to-site Never Works primarily out-of-the office selling products/services (sales employees) Never Physical work site required reputed company Lifting: up to 10 pounds Constantly Lifting: 10 to 25 pounds Never Lifting: 25 to 50 pounds Never Disclaimer: The job reputed company has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees reputed company this job title. It may not contain a comprehensive inventory of reputed company duties, responsibilities, and qualifications required of employees to do this job. Compliance Requirement: This job adheres to the ethical and reputed company standards and behavioral expectations as set forth in the reputed company of business conduct and company policies. As a component of job responsibilities, employees may have reputed company to covered information, cardholder data, or other confidential customer information that must be protected at reputed company times. In reputed company with this, reputed company must reputed company with both the Health Insurance Portability Accountability reputed company of 1996 (HIPAA) as described in the Notice of reputed company Practices and reputed company Policies and Procedures as reputed company as reputed company data reputed company guidelines established reputed company reputed company’s Handbook of reputed company Policies and Practices and Information reputed company Policy. Furthermore, it is every employee’s responsibility to reputed company with reputed company’s reputed company of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as reputed company as company policies and training requirements. Pay reputed company Minimum: $92,300.00 Pay reputed company Maximum: $172,500.00 reputed company pay is determined by a reputed company of factors including a candidate’s qualifications, experience, and expected contributions, as reputed company as internal peer equity, market, and business considerations. The displayed salary reputed company does not reflect any geographic reputed company reputed company may apply for certain locations based upon comparative markets. reputed company and its affiliates prohibit discrimination against reputed company individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against reputed company individuals based on any category protected by applicable federal, state, or local law. We reputed company to reputed company this site accessible to any and reputed company users. If you would like to contact us regarding the accessibility of our website or need assistance completing the application process, please contact the email below. For accommodation requests, please contact HR Services Online at HRServices@reputed company.org California Consumer reputed company reputed company Employees, Contractors, and Applicants Notice Apply tot his job Apply To this Job