Correspondence Policy Specialist

Job not on LinkedIn

🕒 August 27

🇺🇸 United States – Remote

💵 $25 / hour

⏰ Full Time

🟡 Mid-level

🟠 Senior

🦅 H1B Visa Sponsor

This company has sponsored H1B visas in the past.

👻 Ghost score 13%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Evolent

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

⚕️ Healthcare Insurance

🏥 Healthcare

☁️ SaaS

Healthcare Insurance • Healthcare • SaaS

Evolent is a healthcare company focused on improving care outcomes through its comprehensive management solutions across multiple medical specialties. They aim to enhance the patient care journey by offering coordinated services in areas like oncology, cardiology, musculoskeletal disorders, and primary care, while ensuring high-quality treatment pathways and cost management. Evolent believes every person deserves quality care, striving to align treatment guidelines and innovative approaches to meet patient needs effectively.

📋 Description

• Develop and customize clinical correspondence according to regulatory and contractual requirements • Coordinate Compliance Department approval for new and existing business correspondence • Oversee appropriate correspondence use and review requests for new or modified templates • Oversee clinical correspondence for all products in collaboration with Compliance • Update templates to meet NCQA, URAC, ERISA, CMS, and company policy standards • Solve problems and negotiate with internal and external customers regarding complex concepts and competing interests • Mitigate risk and avoid Corrective Action Plans • Research state regulatory requirements for clinical correspondence and policies using online technology and research tools • Consult with IT to support the letter generation process

🎯 Requirements

• 3+ years of healthcare industry experience • 3+ years of experience with compliance and quality requirements related to healthcare and UM processes • Associate degree preferred; 2 or more additional years of experience may be considered instead • Analytical and problem-solving skills • Strong interpersonal, consultation, organizational, tracking, and follow-up skills • Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups and organizations into a written product • Excellent verbal and written communication skills • Knowledge of legislative and oversight bodies, including NCQA, URAC, ERISA, and CMS preferred • Government-issued photo ID required for identity verification • Comprehensive background check required • In-person I-9 verification required • May be subject to drug screening prior to employment • High-speed internet over 10 Mbps at home • Ability to plug directly into the home internet router for call center employees • AI tools prohibited and monitored during interviews

🏖️ Benefits

• Work/life balance • Flexible work arrangements • Autonomy in getting work done • Health insurance benefits for qualifying employees