Capital Blue Cross
Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.
Medical Health Insurance • Dental Insurance • Vision Insurance • Life Insurance • ASO
Manager - Medical Policy and Corporate Coding
4 days ago
Capital Blue Cross
Capital Blue Cross is a health insurance company that offers a range of health plans for individuals, families, and employers. They serve customers in Central Pennsylvania and the Lehigh Valley, focusing on providing health coverage services such as Medicare plans, student health plans, and resources for managing medical care. Capital Blue Cross positions itself as a partner in health, emphasizing support for members' overall wellness and preventive health measures.
Medical Health Insurance • Dental Insurance • Vision Insurance • Life Insurance • ASO
📋 Description
• Provide oversight and management of Capital’s Medical Policy and Coding (MPC) department activities and staff • Ensure compliance with all applicable regulatory and accreditation requirements • Serve as the MPC subject matter expert across the organization • Oversee coding support and consultative activities performed by MPC staff • Maintain collaborative relationships with key stakeholders in the MPC process • Ensure policy alignment with high-quality, evidence-based literature and guidelines
🎯 Requirements
• 5 years clinical experience required with two years management experience • 1 year staff, team lead or project lead experience • 3 years experience in a managed care/health insurance environment preferred • Experience coordinating and leading complex, multi-departmental initiatives and driving results to achieve shared goals
🏖️ Benefits
• Medical, Dental & Vision coverage • Retirement Plan • Paid Time Off • Holidays • Volunteer time off • Incentive Plan • Tuition Reimbursement • More
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