Job Description
**Resp & Qualifications**
**PURPOSE:**
Manages end-to-end oversight of payment policy initiatives in conjunction with Medical Policy, Utilization Management and Configuration teams. Drives teams and internal projects to maintain and enhance program performance over time. Guides stakeholders through key decisions, communicates and coordinates activities internally and across departments. Facilitates process improvement and identifies and articulates stakeholder needs to drive strategies and maximize outcomes related to ROI, provider satisfaction, and organizational metrics and performance. The ideal candidate will have experience in payment policy, utilization management, medical coding and knowledge of Facets. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst...
**PURPOSE:**
Manages end-to-end oversight of payment policy initiatives in conjunction with Medical Policy, Utilization Management and Configuration teams. Drives teams and internal projects to maintain and enhance program performance over time. Guides stakeholders through key decisions, communicates and coordinates activities internally and across departments. Facilitates process improvement and identifies and articulates stakeholder needs to drive strategies and maximize outcomes related to ROI, provider satisfaction, and organizational metrics and performance. The ideal candidate will have experience in payment policy, utilization management, medical coding and knowledge of Facets. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst...