Familiarity with project management discipline preferred.

Responsible for the development, approval, and maintenance of corporate clinical correspondence to ensure compliance with legislative and accreditation requirements. Adheres to procedures, designated roles and responsibilities as outlined in the corporate correspondence policy.

• Develops and customizes correspondence according to regulatory requirements and contractual requirements including coordinating Compliance Department approval for new and existing business.


• Provides oversight of the use of appropriate correspondence and review requests for new or modifications to existing correspondence templates.


• Oversees clinical correspondence for all products in collaboration with Compliance.


• Updates clinical correspondence templates as needed to ensure they meet the minimum standards for National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), Employee Retirement Income Security Act of 1974 (ERISA), Centers for Medicare and Medicaid Services (CMS), and Company Policy across product lines and business segments.


• Tasked with problem solving and negotiation with internal and external customers around complex concepts and competing interests for risk mitigation and avoidance of Corrective Action Plans.


• Researches state regulatory requirements for clinical correspondence and policies using online technology and research tools.


• Consults with IT to support the letter generation process.

Responsibilities
2+ years of healthcare industry experience.
2+ years of experience with compliance and quality requirements related to healthcare and UM processes.
Associates preferred but consideration for 2 or more additional years of experience will be considered.
Analytical/problem solving skills
Strong interpersonal, consultation, organizational, tracking and follow-up skills.
Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups and organizations into a written product.
Possesses excellent verbal and written communication skills.
Knowledge of legislative/oversight bodies (e.g., National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), Employee Retirement Income Security Act of 1974 (ERISA), Centers for Medicare and Medicaid Services (CMS)).

General Job Information

Title
Correspondence Policy Specialist

Grade
20

Work Experience - Required
Healthcare, Operations

Work Experience - Preferred

Education - Required
A Combination of Education and Work Experience May Be Considered., Associate

Education - Preferred

License and Certifications - Required

License and Certifications - Preferred

Salary Range

Salary Minimum:
$41,505
Salary Maximum:
$62,255

This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.

This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing.

Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.
Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.