Policy Governance Professional - REMOTE
About The Position
This position is posted by Jobgether on behalf of a partner company. We are currently looking for a Policy Governance Professional. In this role, you will play a crucial part in the development and management of Utilization Management (UM) policies and procedures, working closely with governance committees to ensure compliance with regulatory standards. Your responsibilities will involve the preparation of clear documentation and reports that support organizational objectives and continuous improvement initiatives. With a focus on quality metrics, your insights will directly inform decision-making processes and enhance the overall consumer experience.
Requirements
- Bachelor's degree.
- Less than 5 years of technical experience.
- Experience with UM operations, policy governance, committee support, and/or quality reporting in a healthcare environment.
- Strong written communication and documentation skills.
- Familiarity with regulatory standards (e.g., HIPAA, HITRUST, NIST) and compliance practices.
- Must be passionate about contributing to an organization focused on continuously improving consumer experiences.
Responsibilities
- Assist with the development, review, and maintenance of UM policy and procedure documentation, ensuring compliance with regulatory requirements and enterprise standards.
- Support UM governance activities and provide committee support by preparing meeting materials, documenting meeting minutes, and tracking action items.
- Collect, analyze, and report on UM quality metrics to inform decision-making and support continuous improvement efforts.
- Prepare clear, concise, and accurate written communications, summaries, and reports related to UM governance, quality metrics, and policy activities.
- Facilitate communication and training related to UM policy requirements, reporting resources, and compliance protocols.
- Assist with the escalation and documentation of suspected policy violations in accordance with established procedures.
Benefits
- Health benefits effective day 1.
- Paid time off, holidays, volunteer time and jury duty pay.
- Recognition pay.
- 401(k) retirement savings plan with employer match.
- Tuition assistance.
- Scholarships for eligible dependents.
- Parental and caregiver leave.
- Employee charity matching program.
- Network Resource Groups (NRGs).
- Career development opportunities.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
11-50 employees
