Job Description

Awarded a Healthiest Employer, Blue Cross Blue Shield of Arizona aims to fulfill its mission to inspire health and make it easy. AZ Blue offers a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

This position requires work and residency to be performed within the state of Arizona.

Purpose of the job

Facilitate the publication of Medical Coverage Guidelines to provide guidance for members, providers and internal and external customers.

REQUIRED QUALIFICATIONS

Required Work Experience
  • 3 year(s) of experience in office or clerical field (All Levels)
  • 1 year(s) of experience in document management field (Applies to Level 2)

Required Education

  • High-School Diploma or GED in general field of study (All Levels)

Required Licenses

  • N/A

Required Certifications

  • N/A

PREFERRED QUALIFICATIONS

Preferred Work Experience
  • 1 year(s) of experience in healthcare, medical or insurance office or clerical field (All Levels)
  • 1 year(s) of experience in technical writing, journalism, document publication or related field (All Levels)
Preferred Education
  • Associate’s Degree  in related field of study (All Levels)
  • Bachelor’s Degree in related field of study (All Levels)
Preferred Licenses
  • N/A
Preferred Certifications
  • N/A
 

ESSENTIAL job functions AND RESPONSIBILITIES

Level 1 - Under the direction and review of the Level 2 Document Management Specialist:

  • Review, design, edit, reformat and maintain coverage guidelines
  • Publish Medical Coverage Guidelines (MCGs) internally on DocCenter and externally on BCBSAZ Internet provider and member portals
  • Weekly communication of MCGs update information to applicable areas of the corporation relying upon this information on a weekly or as needed basis
  • Respond to internal customer inquiries and requests for information regarding coverage guidelines
  • Provide/maintain the following:
  • Department policies and procedures
  • MCG development files
  • 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
  • Provider and vendor letters
     

Level 2 - Working independently:

  • Provide/maintain the following
  • Internet MCG tracking system
  • DocCenter MCG tracking system
  • Responsible for monitoring the access to all Medical Coverage Guidelines located on BCBSAZ Internet provider and member portals.
  • Perform internal (DocCenter) and external (BCBSAZ Internet provider and member portals) audits to maintain quality and resolve issues
  • Responsible for the training, development and support of grade level I staff under an established training program
  • Bi-monthly Medical Policy Panel meeting preparation
  • Accountable for maintaining all  HUM-1 documents to support URAC compliance
  • Develop and maintain DMS Policy & Procedures (P&P)
  • Finalize and publish department P&Ps; maintain P&P tracking system
  • Facilitates Informatics and IT reporting requests
  • Assists manager in policy and procedure development
  • Assists manager in development, revision and review of publication efficiencies
     

all levels

  • Each progressive level includes the ability to perform the essential functions of any lower levels.
  • The position requires a full-time work schedule. Full-time is defined as working at least 40 hours per week, plus any additional hours as requested or as needed to meet business requirements.
  • Perform all other duties as assigned.

competencies

REQUIRED COMPETENCIES

Required Job Skills (Applies to All Levels)

  • Intermediate skill in use of office equipment, including copiers, fax machines, scanners and telephones
  • Intermediate PC proficiency
  • Intermediate Adobe PDF Standard proficiency
  • Intermediate Microsoft Office Suite proficiency
  • Intermediate proofreading skills

Required Professional Competencies (Applies to All Levels)

  • Maintain confidentiality and privacy
  • Practice interpersonal and active listening skills to achieve customer satisfaction
  • Establish and maintain working relationships in a collaborative team environment
  • Follow and accept instruction and direction
  • Organizational skills with the ability to prioritize tasks and work with multiple priorities
  • Compose a variety of business correspondence
  • Independent and sound judgment with good problem solving skills

Required Leadership Experience and Competencies

  • N/A

PREFERRED COMPETENCIES

Preferred Job Skills (Applies to All Levels)

  • Advanced skill in use of office equipment, including copiers, fax machines, scanners and telephones
  • Advanced PC proficiency
  • Advanced Adobe PDF Standard proficiency
  • Advanced Microsoft Office Suite proficiency
  • Advanced proofreading skills

Preferred Professional Competencies

  • N/A

Preferred Leadership Experience and Competencies (Applies to All Levels)

  • Participate in strategic planning
  • Resolve conflicts
  • Represent BCBSAZ in the community

Our Commitment

AZ Blue does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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