Job Information
TELLIGEN AutoAuth Rules Writer in WEST DES MOINES, Iowa
\ \ \ \ Position:\ AutoAuth Rules Writer\ \ \ \ \ \ \ \ Location:\ \ \ West Des Moines, IA\ \ \ \ \ \ \ \ Remote Status: Remote\ \ \ \ \ Job Id:\ 3468\ \ \ \ \ # of Openings:\ 1\ \ \ \ \ \ \ \ \
AutoAuth Rules Writer
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As an AutoAuth Rules Writer, you will be responsible for providing project administrative support for multiple contracts and customers by utilizing the Medicare Milliman Clinical Guideline (MCG) Modification Module to create, copy, or revise a policy or guideline. The incumbent supports the development of business-specific documents. Business-specific documents may include but are not limited to, MCG AutoAuth rules and guideline modification, manuals, reports, spreadsheets, graphs, PowerPoint presentations, and educational materials.
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In this role, you will:
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- Work with clinicians to create, copy, and/or revise clinical guidelines and create and/or modify auto authorization rules.
- Act as the point of contact for product and technical issues.
- Communicate plans and status across relevant internal teams.
- Communicate and educate external and internal uses of Care Web QI (CWQI) and the Qualtrics auto authorization engine.
- Provide feedback and suggestions on improvement in guidelines and auto authorization rules.
- Utilize test/stage environments to isolate problems with created guidelines and rules.
- Document and track all guideline modifications and auto authorization rules in a central location available to all relevant stakeholders.
- Create, update, and monitor timelines.
- Coordinate documentation from multiple sources.
- Ensure online or hard copy materials are accurate and in a professional format according to contract/program requirements.
- Monitor the status of auto authorizations for each contract.
- Track auto authorization utilization per contract and report quarterly on MOR.
- Update auto authorization rules as needed with criteria updates.
- Report variations or discrepancies to management.
- Ensure files are up-to-date and accurate.
- Research and make recommendations to the team for process improvements.
- Prepare documentation, including writing, assisting with writing, or formatting (agenda, minutes, handouts, manuals, publications, deliverables, reports, and educational materials according to contract/program requirements, etc.) for internal team meetings and/or external customer meetings to support the team.
- Mentor and orient other employee-owners in auto authorization rules production and testing.
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What You\'ll Need:
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Two-year degree in business, healthcare, IT, or related field and/or equivalent training and/or experience.
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3 - 4 years of experience in project administrative support.
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Demonstrated ability working with confidential information and in a deadline-driven environment.
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Demonstrated ability to effectively multi-task and problem-solve.
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- Demonstrated knowledge and use of the MCG guidelines used for business rules to include, but not limited to: Ambulatory Care, Inpatient and Surgical Care, General Recovery Care, Home Care, Chronic Care, and Behavioral Health Care.
- 5% local and overnight travel.
- Advanced knowledge and experience with Windows, all Microsoft Office products, and other PC-based software.
- Ability to work within multiple software environments and acclimate to client or project-specific software.
- Familiarity with medical terminology is a plus.
- We are unable to consider candidates outside of the United States, candidates in the state of California, or those in US Minor outlying islands and territories.
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COMMITMENT TO SAFETY\ As part of our com itment to health and safety, some roles may require additional health protocols (i.e. personal protective equipment or vaccination)
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Who We Are:
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Telligen is one of the most respected population health management organizations in the country. We work with state and federal government programs, as well as employers and health plans offering clinical, analytical, and technical expertise.
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Health has changed a lot through our 50-year history, but what has remained constant is that we care deeply about who we serve and what we do. Our success is built on our ability to adapt, respond to client needs, and offer innovative solutions at every turn.
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Our business is our people and we\'re looking for talented individuals who not only believe in our mission but who are ready to take ownership and make a difference in the lives of people, in the world of health. Learn more about who we are and what we do at
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Are you Ready?
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We\'re on a mission to transform lives and economies by improving health and getting there means following through on our values of Ownership, Community, Ingenuity and Integrity.
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- Ownership: As a 100% employee-owned company, our employee-owners drive our business, our solutions, and share in our success. When employee-owners grow and thrive, we all win.
- Community: Putting others first and being a good corporate partner wherever we work, and play makes us who we are. We Show Up. For our clients, for our communities, and for each other.
- Ingenuity: We\'re a team of passionate professionals driven by hard work and big ideas. We understand that high-value breakthroughs come from taking calculated risks. If it will benefit our clients and advance our mission, we\'re all ears. We celebrate free-thinking and challenge the status quo, so brainstorm away!
- Integrity: Smiling faces (virtual or in-person) are the norm around here. We enjoy a friendly work environment where everyone is dedicated to mutual trust, respect, and excellence.
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Thank you for your interest in Telligen!
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Follow us on Twitter, Facebook, and LinkedIn to learn more about our mission-driven culture and stay up to speed.
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- Telligen and our affiliates are Affirmative Action, Equal Opportunity Employers (EOE/M/F/Vet/Disability), and E-Verify Participants.
- Telligen will not provide sponsorship for this position. If you will require sponsorship for work authorization now or in the future, we cannot consider your application at this time.
- Telligen does not accept 3rd party solicitations from outside staffing firms.
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