Document Management Specialist I

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

• Associates Degree in related field of study (All Levels)
• Bachelors 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.