CrawlJobs Logo

Med Policy Development/Research Specialist

United States, Phoenix · Job Posted January 04, 2026
Apply Position
Job Link Share

Job Description

Perform medical technology research to support the Medical Director Staff and Medical Policy Panel with decisions to ensure that medical policies are consistent with the standards of accepted medical practice in the community.

Job Responsibility

  • Perform medical technology research related to coverage guidelines and new technology and provide evaluation and summarization to Medical Director Staff and/or Medical Policy Panel
  • Perform medical technology research as requested by other areas of BCBSAZ thru the Medical Policy Referral Form
  • Develop and revise coverage guidelines and criteria as requested by management, Medical Director staff or Medical Policy Panel
  • Communicate medical policy information in protocol format to all areas of BCBSAZ requiring this information
  • Participate as a contributing member on the Medical Policy Panel providing medical policy issues for discussion and, as required, on the Clinical Coding Governance Committee (CCGC)
  • Maintain a thorough knowledge of all BCBSAZ medical coverage guidelines and other policies
  • From the direction of management, Medical Director staff or Medical Policy Panel, facilitate external consultant reviews concerning a coverage guideline or new technology
  • Communicate medical policy information in protocol format to healthcare providers upon request
  • With moderate assistance and review by management, perform basic level of code review
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations
  • Maintain all standards in consideration of State, Federal, BCBSAZ and other accreditation requirements
  • The position has an onsite expectation of 1 day per week and requires a full-time work schedule
  • Perform all other duties as assigned

Requirements

  • 2 year(s) of experience in clinical field of practice, health insurance, or other health care related field
  • 1 year(s) of experience in medical policy and technology research field (Applies to Level 2)
  • 2 year(s) of experience in medical policy and technology research field (Applies to Level 3)
  • Associate’s Degree in general field of study or Post High School Nursing Diploma or Certification (LPN only) from an approved program
  • Active, current, and unrestricted license to practice in the State of Arizona (a state in the United States) as a health professional, including RN, LPN, LPT, LBSW, LMSW, or LCSW.
  • Intermediate PC proficiency
  • Intermediate Adobe PDF Standard proficiency
  • Intermediate word processing, spreadsheet and presentation software proficiency
  • Maintain confidentiality and privacy
  • Advanced clinical knowledge
  • Practice interpersonal and active listening skills to achieve customer satisfaction
  • Compose a variety of business correspondence
  • Follow and accept instruction and direction
  • Establish and maintain working relationships in a collaborative team environment
  • Organizational skills with the ability to prioritize tasks and work with multiple priorities
  • Independent and sound judgment with good problem solving skills

Nice to have

  • 3 year(s) of experience in clinical field of practice, health insurance, or other health care related field
  • 1 year(s) of experience in claims retrospective review, utilization management, case management, appeals and grievances or quality review field
  • Bachelor's Degree in Nursing or related field of study
  • Active, current, and unrestricted State of Arizona (a state in the United States) license to practice as a Registered Nurse
  • Advanced PC proficiency
  • Advanced Adobe PDF Standard proficiency
  • Advanced processing, spreadsheet and presentation software proficiency
  • Participate in strategic planning
  • Resolve conflicts
  • Represent BCBSAZ in the community

Looking for more opportunities?

Search for other job offers that match your skills and interests.

Similar Jobs for

Med Policy Development/Research Specialist

8 matching positions

Rn Med Policy Development/Research Specialist

Perform medical technology research to support the Medical Director Staff and Me...
Location
Location
United States , Phoenix
Salary
Salary:
Not provided
azblue.com Logo
Blue Cross Blue Shield of Arizona
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • 2 year(s) of experience in clinical field of practice, health insurance, or other health care related field (All Levels)
  • 1 year(s) of experience in medical policy and technology research field (Applies to Level 2)
  • 2 year(s) of experience in medical policy and technology research field (Applies to Level 3)
  • Associate’s Degree in general field of study or Post High School Nursing Diploma or Certification (LPN only) from an approved program (Applies to All Levels)
  • Active, current, and unrestricted license to practice in the State of Arizona as a health professional, including RN, LPN, LPT, LBSW, LMSW, or LCSW. (Applies to All Levels)
  • Intermediate PC proficiency
  • Intermediate Adobe PDF Standard proficiency
  • Intermediate word processing, spreadsheet and presentation software proficiency (Applies to All Levels)
  • Maintain confidentiality and privacy
  • Advanced clinical knowledge
Job Responsibility
Job Responsibility
  • Perform medical technology research related to coverage guidelines and new technology and provide evaluation and summarization to Medical Director Staff and/or Medical Policy Panel
  • Perform medical technology research as requested by other areas of BCBSAZ thru the Medical Policy Referral Form
  • Develop and revise coverage guidelines and criteria as requested by management, Medical Director staff or Medical Policy Panel
  • Communicate medical policy information in protocol format to all areas of BCBSAZ requiring this information
  • Participate as a contributing member on the Medical Policy Panel providing medical policy issues for discussion and, as required, on the Clinical Coding Governance Committee (CCGC)
  • Maintain a thorough knowledge of all BCBSAZ medical coverage guidelines and other policies, such as BCBS Association Medical Policy Reference Manual, MCG care guidelines and/or Change Healthcare InterQual, and eviCore criteria
  • From the direction of management, Medical Director staff or Medical Policy Panel, facilitate external consultant reviews concerning a coverage guideline or new technology
  • Communicate medical policy information in protocol format to healthcare providers upon request
  • With moderate assistance and review by management, perform basic level of code review
  • Meet quality, quantity and timeliness standards to achieve individual and department performance goals as defined within the department guidelines and required by State, Federal and other accrediting organizations
  • Fulltime
Read More
Arrow Right

Electrical Tester

Liberty has a fantastic opportunity for an Electrical Tester to join our growing...
Location
Location
United Kingdom , Liverpool
Salary
Salary:
38313.00 GBP / Year
jobs.360resourcing.co.uk Logo
360 Resourcing Solutions
Expiration Date
June 15, 2026
Flip Icon
Requirements
Requirements
  • Proven experience in electrical testing (EICRs)
  • 2391 Testing & Inspection (or equivalent)
  • 18th Edition (BS7671)
  • Full UK driving licence
Job Responsibility
Job Responsibility
  • Carrying out EICRs in social housing
  • Diagnosing and resolving electrical faults
  • Repairing and replacing electrical fittings
  • Working in line with Health & Safety and company policies
What we offer
What we offer
  • Competitive salary + uncapped bonus potential
  • Company van & fuel card
  • 23 days leave + bank holidays
  • Wellbeing support (24/7 GP, mental health, fitness resources)
  • Ongoing training & development
  • Supportive, high-performing team environment
  • Fulltime
Read More
Arrow Right

Customer Assistant - Cashier

Do you have Cash Office experience? Are you comfortable with Cash Handling and R...
Location
Location
United Kingdom , Ipswich
Salary
Salary:
12.71 GBP / Hour
jobs.360resourcing.co.uk Logo
360 Resourcing Solutions
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Experience in delivering first class, personalised customer service in a face-to-face role, preferably in a hospitality, retail or leisure environment
  • Outstanding communication skills that can be adapted to different situations when necessary
  • Experience of handling cash and basic numeracy knowledge
  • You are confident at challenging the way things are done and can make sure all Customers follow our company policies and standards
  • Applicants must be 18+
Job Responsibility
Job Responsibility
  • Build rapport and relationships with Customers
  • Be flexible on tasks across all areas of the Club from front of house, book sales, treasury, machines, the bar area and kitchen including, general housekeeping throughout the Club, checking the toilets and ensuring presentation is always to a high standard
  • Support with other duties as requested by the line manager
  • Ensuring you create a Safer Gambling Environment for all our Customers and Colleagues across all of our channels
  • online, in club and live
What we offer
What we offer
  • Help@Hand – a physical and mental wellbeing app for you and your family giving you fast remote access to a GP for advice and more
  • Thrive App – for your mental wellbeing approved by the NHS
  • Buzz Brights Apprenticeships
  • Buzz Brilliance Awards – Employee Recognition Scheme
  • Buzz Learning, our digital learning platform with access to 100s of online courses
  • In-house Training – Fire safety, Food safety 1 & 2, COSHH and more
  • Access to Trained Mental Health Advocates for advice on your mental wellbeing
  • 4 weeks Annual Leave plus Public Holidays (Prorated accordingly for part time Colleagues)
  • Buy Holidays Salary Sacrifice Scheme – opportunity to buy an extra week’s holiday (if eligible)
  • Staff discount 50% off bingo tickets, food & soft drinks
  • Parttime
Read More
Arrow Right
New

Sr. Consultant

Location
Location
United States , Southborough
Salary
Salary:
150000.00 - 250000.00 USD / Year
bbrown.com Logo
Brown & Brown UK
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Bachelor's degree required
  • At least 7 years of experience in employee benefits consulting
  • Broad health and benefits market knowledge
  • Proven ability to build strong client relationships and communicate effectively
  • Advanced analytical and financial evaluation skills
  • Proficiency in Microsoft Office Suite (Excel, Word, PowerPoint)
  • Life and Health license (must be obtained within 90 days of hire)
Job Responsibility
Job Responsibility
  • Drive business results through exceptional client service, management, and retention
  • Lead complex client workflows, overseeing all aspects of service delivery including strategy development, financial evaluations, plan design, renewals, vendor placement, benchmarking, and related studies
  • Design advanced benefits strategies in partnership with actuarial, communication, pharmacy, and population health teammates to create innovative solutions to address challenging client needs
  • Manage complex projects and teams, ensuring timely delivery of client deliverables and high-quality outcomes
  • Analyze data and financial metrics, conduct utilization reviews, and perform peer audits to maintain accuracy and quality
  • Coordinate RFPs, implementations, and renewals, managing communication and collaboration between vendors and internal teams, summarizing analysis, and developing client recommendations
  • Support clients’ strategic planning efforts, contributing insights and recommendations to align with long-term goals
  • Review compliance and disclosure requirements, summary plan documents, and employee communications to support clients in their compliance obligations
  • Act as a trainer and mentor, guiding consultants and analysts to build expertise and confidence
  • Develop strong relationships across internal teams, client organizations, and vendor partners
What we offer
What we offer
  • Health Benefits: Medical/Rx, Dental, Vision, Life Insurance, Disability Insurance
  • Financial Benefits: ESPP
  • 401k
  • Student Loan Assistance
  • Tuition Reimbursement
  • Mental Health & Wellness: Free Mental Health & Enhanced Advocacy Services
  • Beyond Benefits: Paid Time Off, Holidays, Preferred Partner Discounts and more
  • Fulltime
Read More
Arrow Right

Product Marketing Manager

Product Marketing Manager The position is liaison between Arrow's suppliers and...
Location
Location
Taiwan , New Taipei City
Salary
Salary:
Not provided
arrow.com Logo
Arrow Electronics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Good communication skills
  • Fluent in Mandarin, English, Cantonese
  • Experience in Microsoft Excel, Word & Outlook
  • Enthusiastic, driven, energetic & motivated
  • Aggressive personality
  • Bachelor's degree, major Electronic Engineering, Computer Engineering or equivalent
  • 5+ year experience including 2-3 years as product management role in semi industry
  • knowledge on power products in greater China Market, especially on Artesyn, Nordic, Semtech
Job Responsibility
Job Responsibility
  • Responsible for Product Marketing for assigned product lines
  • Build a strong supplier relationship for joint business growth in target area
  • Define and executive marketing strategies
  • Liaise with colleagues for common business goal
  • Demand creation
  • New business development
  • Arrange meetings via webcast, phone or in person in order to drive and increase market share
  • Learns the process of returns, quotes, delivery, pricing and special restrictions
  • Identifies manufacturing problems to resolve delivery response issues and utilizes management's help when necessary
  • Investigates price anomalies across all regions and works to maintain price stability
What we offer
What we offer
  • Group life Insurance
  • Performance Bonus
  • Paid Time Off
  • Special/Extra Leave
  • 5-Day Work Week
  • Growth Opportunities
  • Fulltime
Read More
Arrow Right

Mobile Associate - Retail Sales

Location
Location
United States , South Burlington
Salary
Salary:
19.50 - 20.00 USD / Hour
https://www.t-mobile.com Logo
T-Mobile
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • High School Diploma/GED (Required)
  • 6 months of customer service and/or sales experience, Retail environment preferred. (Required)
  • Passionate customer advocate with the desire to be yourself when connecting and having fun doing it! (Required)
  • Competitive drive and proven ability to succeed in a fast-paced sales environment. (Required)
  • Willingness to work alongside peers and store leaders, learning and sharing ideas, while serving customers and providing resolutions to issues. (Required)
  • Effective at balancing customer needs and performance goals. (Required)
  • At least 18 years of age
  • Legally authorized to work in the United States
Job Responsibility
Job Responsibility
  • Builds proficiency related to serving and selling to our customers
  • Helping customers pick up right where they left off in their shopping journey
  • Exploring individual needs and providing hands-on demonstrations of the latest and greatest technology in-store
  • Side-by-side selling to find personalized solutions beyond the bare-bones device and service plan
  • Approaching service and sales needs with composure, integrity and compassion
  • Becomes skilled with and consistently uses digital tools in interactions and onboarding
  • Completes training on T-Mobile in-store experience, new skills and processes
  • Makes the most of their time on shift
  • Establishes relationships with and partners with T-Mobile employees across channels
  • Collectively own the customer experience and resolve issues
What we offer
What we offer
  • Medical, dental and vision insurance
  • Flexible spending account
  • 401(k)
  • Employee stock grants
  • Employee stock purchase plan
  • Paid time off
  • Up to 12 paid holidays
  • Paid parental and family leave
  • Family building benefits
  • Back-up care
  • Parttime
Read More
Arrow Right

Sr. Field Application Engineer

Location
Location
Korea, Republic Of , Seoul
Salary
Salary:
Not provided
arrow.com Logo
Arrow Electronics
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Strong technical understanding of MCU / Connectivity Software engineering system which covers Programming Language: C/C++
  • Secure Design-in/win for the Connectivity (Matter/BT/BLE and Wi-Fi solutions) for the IoT, Consumer, Automotive market
  • Support customer technical issues throughout their system design and production periods of time
  • Provide technical training to the customers
  • Prefer NXP / STM / INFINEON / Silicon Labs business experience
  • Prefer FAE experience in distributor
  • Wifi, BLE, Thread, Zigbee, Wisun, Sub G, etc
  • DSP, MPU and MCU
  • RTOS, Linux, Android, Window, etc
  • Hardware design
Job Responsibility
Job Responsibility
  • Strong technical understanding of MCU / Connectivity Software engineering system which covers Programming Language: C/C++
  • Secure Design-in/win for the Connectivity (Matter/BT/BLE and Wi-Fi solutions) for the IoT, Consumer, Automotive market
  • Support customer technical issues throughout their system design and production periods of time
  • Provide technical training to the customers
  • Fulltime
Read More
Arrow Right

Radiologic Technologist, Diagnostic Imaging, PRN, Baptist South

Baptist Health is currently looking to add a Radiology Technologist to our Imagi...
Location
Location
United States , Jacksonville
Salary
Salary:
Not provided
baptistjax.com Logo
Baptist Health (Florida)
Expiration Date
Until further notice
Flip Icon
Requirements
Requirements
  • Vocational School education preferred
  • Licensed Certified Radiologic Technologist (CRT) - DOH
  • Registered Technologist in Radiography - ARRT
  • Basic Life Support (BLS) - AHA
  • Driver's License - DMV
  • Registered Cardiovascular Invasive Specialist (RCIS) - CCI - Cardiovascular
Job Responsibility
Job Responsibility
  • Performing high-quality radiographic procedures
  • Promoting goodwill amongst co-workers and with other departments, and has a positive, comforting demeanor with all patients
  • Reporting to the Lead Technologist on shift
  • Is compliant with mandatory education and health requirements
  • Comfortable with Pediatrics
  • Identifying, preparing, administering, and documenting medications as prescribed by a licensed practitioner, by state and federal regulations, or Lawful institutional policy
What we offer
What we offer
  • Eligible for up to $500 Sign-On Bonus if hired!
Read More
Arrow Right