Medical Policy Strategy Specialist - Remote (MN Residents Only)

Location: Fully Remote
Schedule: Monday-Friday, 8:00 AM-4:30 PM (flexibility within standard business hours)
Compensation: $89,000-$100,000
Employment Type: Temp-to-Hire

Position Overview

This role is responsible for aligning internal evaluation tools, documentation standards, and workflows with external policy and authorization requirements to improve approval outcomes and reduce administrative burden for end users. Serving as the internal expert on policy interpretation and documentation strategy, this individual translates complex guidelines into clear, usable frameworks while driving continuous improvement across authorization and approval processes.

The position partners closely with cross-functional teams to analyze trends, identify root causes of rework or denials, and implement solutions that balance compliance with usability. Success in this role requires strong analytical thinking, process design expertise, and the ability to influence without direct authority.

Key Responsibilities

• Analyze external policy requirements and ensure alignment with internal evaluation tools and documentation practices
• Lead the design, implementation, and optimization of evaluation and justification tools
• Monitor authorization and approval outcomes to identify trends, root causes, and improvement opportunities
• Develop proactive strategies to reduce repeat issues and supplemental information requests
• Translate complex policy requirements into clear, standardized, user-friendly guidance
• Partner cross-functionally to balance compliance needs with ease of use
• Serve as an internal subject matter expert on documentation expectations and approval standards
• Develop, maintain, and audit documentation frameworks to improve success rates and efficiency
• Stay current on evolving policies, regulations, and best practices impacting authorization processes
• Support initiatives that enhance end-to-end approval workflows
• Promote a continuous improvement mindset focused on quality, access, and operational effectiveness
• Perform other related duties as assigned

Qualifications

• Bachelor's degree required; advanced degree or professional background in a regulated environment preferred
• 5+ years of experience in policy analysis, authorization processes, reimbursement, compliance, or related fields
• Hands-on experience with authorization requests, documentation review, and external policy interpretation
• Experience developing evaluation tools, templates, or documentation frameworks strongly preferred
• Strong analytical skills with the ability to interpret and simplify complex requirements
• Excellent written and verbal communication skills
• Ability to manage multiple priorities in a fast-paced environment
• Proven ability to lead initiatives and influence stakeholders without direct authority
• Strong problem-solving and root cause analysis capabilities
• High attention to detail with a focus on accuracy and quality

Contract Benefits (During Temp Period)

• Medical coverage with prescription benefits and virtual care options
• Hospital indemnity coverage
• Dental and vision insurance
• Accident and critical illness coverage
• Life insurance and short-term disability (20+ hours per week)
• Earned safe and sick time per local/state guidelines
• Discount programs for travel, entertainment, and retail

Culture Highlights

• Mission-driven, purpose-focused work
• Collaborative, team-oriented environment
• Flexible, remote-friendly structure
• Employee ownership mentality
• Leadership that values innovation and new ideas
• Supportive team culture with recognition and celebration