Manager Medical Policy *Remote*

The Medical Policy Manager is responsible for the management and supervision of all medical policy development, quality, implementation, publication, and routine updates.  The Policy Manager will coordinate, manage, and direct all aspects of the Plan's policy life cycle and will ensure all coding, regulatory, legal, operational, and evidence-based best practices are maintained, consistent and documented across all Policy Teams.  Critical to the success of this role is demonstration of mange care savings targets of +$7 million annually directly related to implementation of new policies with positive ROI. This role will direct reports that will include Master's and PhD-level Medical Policy Analysts, Policy Coordinators, and other caregivers, as required. The Medical Policy Manager is responsible for building and maintaining strategic internal and external relationships as they relate to administration and operationalization of medical policies for all lines of business, clients, and business partners.

Providence caregivers are not simply valued – they’re invaluable. Join our team at Providence Health Plan Partners and thrive in our culture of patient-focused, whole-person care built on understanding, commitment, and mutual respect. Your voice matters here, because we know that to inspire and retain the best people, we must empower them.

Required Qualifications:

• Bachelor’s Degree in Nursing or other clinical or healthcare related field.
• Master's Degree in Healthcare Administration, Public Health.
• 5 years related experience in healthcare policy research and development, preferable in a payer setting.
• 5 years leadership experience.
• 3 years demonstrable experience in program management and project management.
• 3 years experience with assessing and evaluating data analytics.

Preferred Qualifications:

• 3 years experience with CMS, Medicaid, and state(s) regulatory requirements and quality accreditation bodies (e.g., NCQA).

Why Join Providence? 

Our best-in-class benefits are uniquely designed to support you and your family in staying well, growing professionally, and achieving financial security. We take care of you, so you can focus on delivering our Mission of caring for everyone, especially the most vulnerable in our communities.