Job description
The Medical Policy Coordinator has primary responsibility for the maintenance of the Medical Policy & Coding SharePoint site, updating and creation of new fields as needed, training of new staff on use of SharePoint and related databases, and communication of Medical Policies. This position ensures that departmental document management and publication are consistent with established policies, procedures, and management direction.
This position will support with their SharePoint needs to include, but not limited to, the following activities/skills within SharePoint:
This position will support with their SharePoint needs to include, but not limited to, the following activities/skills within SharePoint:
- Setting up user permissions.
- Creating and maintaining libraries.
- Internal SharePoint subsite development
- Creating and maintaining training materials for SharePoint users.
- Technical knowledge for basic troubleshooting.
- Exporting reports from SharePoint to Excel.
Essential Job Duties and Responsibilities
- Set up SharePoint user permissions
- Populate SharePoint properties to ensure timely and appropriate workflows. These include, but are not limited to PREP, CAC, Configuration, Provider Communication, and Publication
- Maintain current knowledge of first-line troubleshooting of databases
- Export data and create reports from SharePoint to Excel.
- Serve as MPC owner to SharePoint sites as defined by the Medical Policy Manager with responsibility for the maintenance, upgrading, and redesign exploration and implementation. Collaborate with IT for higher-level SharePoint troubleshooting and redesign.
- Coordinate and standardize provider communications, adhering to timelines and collaborating with MPC and Provider Network Engagement teams.
- Format and coordinate internal/external publication of medical policies, including Capital and Availity web site publications.
- Track and verify remediation for medical policies and other publications as required.
- Validate that Capital and Availity publications occur as scheduled. Track, troubleshoot, and alert leadership to delays or other changes in timing of these publications
- Collaborate with Provider Network and Web Design team regularly.
- Post alerts and updates regarding medical policy and coding information into SharePoint and ensure communication to all involved parties on a continuous basis.
- Actively coordinate SharePoint workflow processes.
- Maintain, update and store SharePoint documentation of MPC project and medical policy work.
- Actively engage in process improvement activities to enhance departmental efficiencies, improve workflows, and upgrade documentation/libraries.
- Assist with the orientation of new employees, including the creation and revision of accurate training materials related to SharePoint and other databases.
- Coordinate work activities with other staff to ensure the timely completion of work tasks to meet departmental, organizational, and regulatory timelines.
- Ensure Web Reporting and NCQA Review reporting are timely, complete, and accurate.
- Create, review, revise, and update MPC Administrative policies related to SharePoint, other databases, and processes for which the Database Specialist is responsible.
- Perform other related duties as assigned.
Job Requirements
- Demonstrate excellent critical thinking skills, organizational skills, and high attention to detail.
- In collaboration with Team Lead, prioritize workload based on departmental needs.
- Cultivate and maintain positive working relationships throughout the organization, collaborating effectively as a member of MPC and other teams.
- Demonstrate capability to communicate effectively with all levels of internal/external personnel to prepare written materials and oral presentations. Compiles meeting minutes and agendas when asked. Communicate effectively both verbally and in writing.
- Demonstrate proficiency in the English language; including but not limited to spelling, punctuation, and grammar required; excellent proofing and editing skills for all types of documents, i.e., written documents, electronic documents, PDF, etc.
- Demonstrate proficiency and use of electronic equipment, i.e., laptop, printer, and other electronic equipment as required for job tasks.
- Maintain a working knowledge of creative electronic documents and develop SharePoint tasks to promote work efficiencies; proficiency in the use of the Microsoft Office Suite including but not limited to Outlook, Word, Excel, Access, and Vizio.
- Adapt to constantly changing priorities.
Knowledge
- Intermediate to advanced user and designer knowledge of SharePoint functionality.
- Knowledge of web-based technologies (Internet/Intranet), SharePoint, Microsoft Access, Microsoft Excel, reporting and testing software, as well as other Microsoft Office Suite tools.
- Preferred basic knowledge of the healthcare industry to include understanding medical terminology
- Includes familiarity with workflows related to medical policies and coding.
- Knowledge of internal work processes, terminology, concepts and regulatory requirements.
- Includes, but is not limited to, knowledge of SharePoint related to medical policy and coding tasks, electronic document storage, publication of medical policies from creation to finalization and notification requirements.
- Comprehensive knowledge of all Microsoft Office applications, including Word, Excel, Access, Outlook, and PowerPoint.
Experience:
Minimum of 3 years of similar work experience, preferably in a health insurance-related position.
Education, Certification, and Licenses:
Minimum of a High School Education/GED - Associates Degree or continued education in a related field is preferred. Medical Terminology. Knowledge related to SharePoint and MS Office products.
Work Environment:
Work at home, office
Travel Requirements:
Occasional (<5% of time)
Physical Demands:
While performing the duties of the job, the employee is frequently required to sit, use hands and fingers, talk, hear, and see. The employee must occasionally lift and/or move up to 5-10 pounds.
Key Interfaces:
Utilization Management, Software Engineering, Applications Systems, Access Coordination, IT&D, Capital web team, internal and external Professional Staff.
Capital Blue Cross is an independent licensee of the Blue Cross Blue Shield Association. We are an equal opportunity/affirmative action employer and do not discriminate on the basis of race, color, religion, national origin, gender, sexual orientation, gender identity, age, genetic information, physical or mental disability, veteran status, or marital status, or any other status protected by applicable law.
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