Policy Governance Professional

📋 Description

• Own and coordinate the end-to-end NCQA Utilization Management (UM) Rates and Timeliness reporting
• Manage reporting calendars, milestones, stakeholder responsibilities, data collection, validation
• Partner with operational, clinical, analytical, quality, compliance, accreditation, and market
• Review reporting results to identify trends, outliers, performance concerns, and opportunities for
• Coordinate, document, and monitor corrective actions and follow-up activities, escalating overdue
• Prepare clear reporting summaries, evaluation findings, recommendations, and presentation materials

🎯 Requirements

• Bachelor's degree in any relevant discipline.
• Professional experience in healthcare operations, utilization management, quality assurance
• Strong working knowledge of Microsoft Excel, PowerPoint, Word, SharePoint, and related
• Ability to coordinate reporting activities, validate data, identify inconsistencies, interpret
• Strong analytical judgment and attention to detail, with the ability to investigate performance
• Excellent organizational and time-management skills, including managing reporting calendars

🎁 Benefits

• Estimated base salary ranging from $65,000 to $88,600, depending on geographic location, relevant
• Eligibility for a bonus incentive plan based on individual and/or organizational performance.
• Medical, dental, and vision benefits designed to support employees and their families.
• Access to a 401(k) retirement savings plan.
• Paid time off, company holidays, and personal holidays to support work-life balance.
• Paid parental and caregiver leave.