Senior Policy Development Analyst

Job not on LinkedIn

🔥 11 minutes ago

⛷️ Utah – Remote

⛷️ Utah – Remote

💵 $31 - $48 / hour

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 Ghost score 0%

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IMH

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2007

🏗️ Construction

📦 Logistics

🛡️ Insurance

Construction • Logistics • Insurance

IMH is the Groupe IMA entity providing end-to-end housing assistance and post-claim services across France. It operates 24/7 emergency call-taking and rapid-response interventions for home incidents (fires, water damage, electrical faults, locksmithing), offers remote damage expertise and cost estimation, and manages repair-in-kind through a national network of vetted contractors. IMH also runs digital platforms to support project estimation and paid home-service offerings, coordinates large-scale catastrophe responses, and connects insurers, beneficiaries and service providers via its accredited prestataire network.

📋 Description

• Lead development and implementation of health plan policies used for adjudication rules, benefit coverage, claims payment programming, and provider reimbursement schedules • Lead policy research from initial request through analysis, recommendation to senior management, and implementation of approved policies • Develop policies aligned with organizational goals, strategies, initiatives, marketing strategies, and required clinical input • Present recommendations, answer questions about analyses and implementation impacts, and present issues based on findings • Oversee approved policy and product change implementation and coordinate implementation teams with affected management and functional areas • Provide policy-specialist support and resources to projects and teams • Maintain current knowledge of business changes, practices, policies, and benefit quoting and adjudication procedures • Oversee coding review, make coverage and benefit determinations for individual codes, and implement changes through documentation, system setup, and provider communication • Champion initiatives requiring policy changes • Participate in functional area committees to ensure consistent policy development • Assist with benefit design, member satisfaction and market research, project tracking, prioritization, and related project management activities

🎯 Requirements

• Four years of policy experience • Two years of experience in a medical benefits or insurance setting, or related work experience providing understanding of claims and eligibility issues, basic medical coding expertise, and insurance product knowledge • Experience managing projects requiring strong interpersonal and organizational skills, ability to perform under stress, and meet deadlines • Excellent oral, written, and interpersonal communication skills • Intermediate skills in computer-based word processing and spreadsheets • Experience with project management, policy, research, operations, analytics, pharmacy or PBM settings, claims adjudication systems, formulary management, benefit configuration, utilization management, regulatory and industry standards, and drug utilization rules are preferred • Bachelor's Degree in a business or healthcare related field is preferred • Four years of project management experience in a regulatory or insurance setting is preferred • Familiarity with NCPDP, formulary and benefit design, prior authorization, step therapy, quantity limits, and other drug utilization rules is preferred • Ability to see and read information, documents, and monitors • Ability to verbally communicate, hear, and understand spoken information • Manual dexterity for frequent computer use • Ability to stand or sit at a desk for extended periods

🏖️ Benefits

• Generous benefits package covering programs for living healthy, happy, secure, connected, and engaged • Remote work expectations related to confidentiality, information security, work schedules, conflicts of interest, and use of company equipment

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