Employer: University of Illinois – Chicago
Hiring Department: DOM Medicaid Advisory Unit
Job Title: Senior Health Policy Specialist (Program Director)
Additional Information: https://uic.csod.com/ux/ats/careersite/1/home/requisition/12132?c=uic&cfdd[0][id]=192&cfdd[0][options][0]=1162
Duties & Responsibilities:
The Senior Health Policy Specialist position contributes to the design and execution of this new consultative partnership program. The position will develop processes and protocols to provide high-level service to state stakeholders. This position will also provide background research and analytical capacity to inform state policy and to support clinician experts in detailed recommendations to the state on a wide range of healthcare issues. The position will support the production and provision of recommendations and expert guidance to OMI and HFS. This is a critical position serving as a policy coordinator with strong analytical skills, consulting and/or collaborating with a broad range of institutional clinicians/stakeholders in providing recommendations and expert guidance to OMI and HFS.
Analysis/Research (Policy Evaluation):
- Provide extensive background research and review to support Medicaid policy recommendations on subjects such as novel pharmaceutical treatments (gene therapy, weight-loss drugs), new services covered under Medicaid (Health-related social needs, eConsultation), and other needs as identified by OMI/HFS.
- Sustain familiarity with current trends in Medicaid payor innovation and reform, with a specific focus on population/value-based health programs and cost-conscious care delivery.
- Collaborate with data analytics teams at OMI and UIC to contribute quantitative analysis of insurance administrative claims data, guiding utilization review and prospective policy analysis.
- Supports multiple OMI partnership projects by ensuring long- and short-term objectives and deliverables in alignment with HFS expectations.
- Tracks relevant state and national research, policies, and legislation to appropriately conceptualize, initiate, and develop appropriate policy guidance.
- Tracks and documents high-level project updates to ensure substantive and comprehensive reporting to OMI and HFS.
- Prepares, organizes, and communicates policy evaluation research results through the development and editing of research briefs and reports to the MAU Medical Director and key OMI stakeholders.
Operations:
- In collaboration with the MAU Medical Director, develop and implement a unified process for managing clinician-expert prior authorization and utilization review across a diverse suite of clinical programs for Illinois Medicaid.
- Maintain processes to deliver timely, high-quality clinical reviews for HFS, including the purchase and set-up of a system of HIPAA-secure project management.
- Support the identification and recruitment of expert physicians and other qualified clinical health care professionals to inform HFS Medicaid policy and/or provide clinical review, as determined by the needs of HFS.
- Develop and maintain relationships with physicians and policy experts internal and external to UIC.
- Develop a policy for management of conflict of interest in clinical review.
Communication:
- Prepare high-quality, professional reports and presentations for stakeholder audiences in response to consultation requests.
- Perform other related duties and participate in special projects as assigned.
Minimum Qualifications Required:
- Bachelor’s degree.
- A total of three (3) years demonstrated experience and applied comprehensive understanding of health policy principles, concepts, practices, and methods to analyze, develop, and implement policies within healthcare systems or related environments.
(Note: Master’s Degree in an area consistent with the duties of the position may be substituted for one (1) year of work experience.
Preferred Qualifications:
- Master’s degree in Health Science field (eg: Masters in Public Health, Public Policy, Health Policy and Administration).
- A minimum of 3 years experience managing complex health projects & analysis
- Possesses and applies advanced knowledge of health policy principles, concepts, practices and methods
- Requires excellent analytical, problem solving skills combined with skills in communication, organization, project management and presentation.
- Quantitative and qualitative research experience
- Advanced writing and communication skills
- Self-starter and can work independently
