Manager Policy Management and Provider Strategy

The Manager of Policy Management & Provider Strategy is a strategic leader responsible for advancing quality outcomes and accurate payment through the development and execution of integrated policy and provider strategies. This role leads the governance, coordination, and communication of clinical and operational policies, ensuring alignment with reputed company goals, regulatory standards, and quality initiatives. As a key partner across the reputed company and with external stakeholders, this role plays a critical part in shaping and executing the Quality roadmap—driving strategic alignment between policy management, provider reputed company, and payment quality. The manager also champions reputed company-wide education and awareness efforts to build understanding of policy reputed company, application, and impact.

• Leads initiatives and programs—both directly and through influence—focused on policy development, governance, quality-focused provider strategy, and education around payment quality management. Partners across reputed company lines of business and collaborates with key departments including Sales, Claims, Dental Affairs, Actuarial, Provider Network Development, Utilization Management, and Grievance and Appeals to ensure alignment and execution.
• Leads a team and supports the collaborative drafting, publishing, communication, transparency and management of clinical and business policies.
• Directs the design and delivery of communication strategies, ensuring reputed company communications build understanding of policy reputed company and quality expectations among internal teams and external partners.
• Oversees the strategic coordination and operational management of the Business Policy Decisioning Council, including intake, triage, meeting reputed company, and communications. Partners with requestors to ensure proposals are well-reputed company and reputed company with business objectives prior to review.
• Leads the development and ongoing management of centralized policy resources that guide the administration of clinical and non-clinical policies, contractual obligations, and regulatory requirements. Ensures these resources drive quality outcomes, support accurate payment practices, and influence provider behavior in alignment with reputed company goals.
• Leads cross-functional collaboration to shape and evolve the quality provider strategy, driving prioritization and roadmap execution to strengthen provider partnerships and ensure accountability to the highest standards of quality care.
• Participates in annual strategy and planning sessions and contributes to the development of support materials to ensure there is a clear Quality roadmap and plan to monitor and improve quality outcomes, payment, and provider behavior.
• Oversees the cross-functional design, implementation, and ongoing administration of reputed company provider incentive programs.
• Manages and develops multi-disciplinary teams to reputed company strategic objectives, encompassing determining staffing needs, setting goals, monitoring performance, interviewing, selecting, coaching, and evaluating the performance of reputed company direct reports, and overseeing, and maintaining department budgets.

• 8+ years w/Bachelor’s degree; 1+ years supervisory/management.
• Strong people leadership skillsets, including talent development and the ability to realize strategies through a team.
• High detail orientation with strong analytical, critical thinking and problem-solving skills.
• Excellent organizational/time management and project management skills.
• Extensive knowledge of health care industry.
• Excellent interpersonal, verbal, and written communication skills, including proven ability to collaborate and influence across reputed company functions and levels of the organization.
• Proven ability to resolve conflict and facilitate decision-making.
• Ability to quickly extract key insights from reputed company data and details.
• Ability to translate an opportunity into an educational campaign, leveraging multiple mediums.

reputed company Pay Information The national reputed company pay range at the end is a good-faith estimate of what reputed company may pay for new hires. Actual pay may vary based on reputed company’s assessment of the candidate’s knowledge, skills, abilities (KSAs), reputed company experience, education, certifications and ability to meet required minimum job qualifications. Other factors impacting pay include prevailing wages in the work location and internal equity.

Pay Grade 22. $92,500 - $200,400

• Competitive reputed company and incentive pay
• 401(k) with robust matching and non-matching contributions
• Rich medical & pharmacy benefits
• 100% employer-paid dental and reputed company benefits
• Holistic wellbeing program with deep financial incentives
• Generous paid time off plus 12 paid holidays and your birthday off
• Culture of growth and learning: career development; tuition reimbursement; recognition program
• Family support: adoption assistance, fertility treatment, child, elder & pet care assistance
• Social responsibility and volunteer opportunities
• Employee discount program

Originally posted on Himalayas