• Job Description

  Req#: 5002258
  Salary: $28.94 - $45.91 Hourly
  Location : Salt Lake County, UT
  Job Type: Full Time
  Remote Employment: Flexible/Hybrid
  Job Number: 45548
  Agency: 250 Health & Human Services
  Unit: 3120 DHHS DIH Healthcare Policy & Authorization
  Opening Date: 07/11/2025
  Closing Date: 8/3/2025 11:59 PM Mountain
  FLSA: Exempt
  Recruiter: Angie Rhodes, arhodes@utah.govq
  # of Openings: 1
  Background Check: You must successfully pass a criminal history check.
  Location: Cannon Health Building288 North 1460 WestSalt Lake City UT 84116 The Utah Department of Health and Human Services, Cannon Health Building is proud to be a tobacco free campus.
  Schedule Code: B - Competitive Career Service - Employment in this position requires a probationary period.
  Schedule Code Description: There may be a 12-month probationary period with this position. DHRM rules regarding promotions and transfers apply to current State of Utah employees.
  Benefits: This position is eligible for a full benefits package. See benefits tab below for details.
  EEO Statement: The State of Utah is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. For accommodations, dial 711 or TTY: 800-346-4128.
  
  Job Description
  The Medical Policy Team within the Office of Healthcare Policy & Authorization (OHPA) is seeking a qualified Medical Policy Analyst to join our dynamic team. This position plays a key role in analyzing, interpreting, updating, and overseeing medical coverage policies while ensuring compliance with state and federal regulations.
  The successful candidate will contribute to the development of detailed medical program guidance, collaborate with internal teams, and help manage core policy functions that impact healthcare delivery across the state.
  Applicants must have at least four (4) years of experience in one or more of the following areas:
  
  • Professional experience working under the employment of Medicaid
  • Certification with the American Academy of Professional Coders (AAPC)
  • Certification with the American Health Information Management Association (AHIMA)
  
  
  The ideal candidate hired for this position will have:
  
  • Strong and well-developed technical writing skills
  • Experience with government healthcare programs, especially Medicaid
  • Proficiency in CPT, HCPCS, ICD-10-CM, and ICD-10-PCS coding systems
  • Familiarity with claims submission, denial resolution, and remittance processes
  • Knowledge of the Integrated Outpatient Code Editor (I/OCE), National Correct Coding Initiative (NCCI), and Medicare Severity Diagnosis Related Groups (MS-DRG)
  • Proven ability to interpret federal and state statutes and translate them into operational policy
  
  Key Responsibilities:
  
  • Consult on policy recommendations aligned with coding regulations and standards
  • Analyze and review claims to assess compliance with coverage criteria
  • Design and revise medical coverage policies in accordance with applicable laws
  • Set project goals, manage resources, track progress, and evaluate outcomes
  • Coordinate with internal stakeholders to ensure successful policy implementation
  
  Note: as of April 8, 2024, DHHS employees will be working a hybrid schedule, which includes 2 office days per week and 3 telework days.
  Why work for the Utah Department of Health and Human Services? In addition to the rich the State of Utah offers, the department offers:
  
  • On-site fitness center, for a minimal membership fee
  • UTA Eco Pass, at a discounted monthly rate
  • Teleworking opportunities with a minimum 2 office days per week beginning 04/2024.
  • On-site day care center at the Cannon Health Building with First Steps Day Care - contact for rates and availability, 385-382-4012 or
  
  For more information on the Utah Department of Health and Human Services, please click
  If offered this position, your employment will be contingent upon passing a background check and review. There will be no cost to you for this check. This check will include fingerprinting, which will be available at various DHHS locations for your convenience. Fingerprinting will be completed prior to your first day of employment. You may review the policy by clicking here.
  Supplemental Information
  
  
  • Effective July 1, 2021, State of Utah Employees must either reside in Utah or be in the process of relocating to Utah within 30 days of their start date.
  • This position may currently be a hybrid of both in-office and remote work days. Please note, a person's eligibility for remote work is establisted by agency management and is subject to change at their discretion, at any time, and for any reason.
  • Risks found in the typical office setting, which is adequately lighted, heated and ventilated, e.g., safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
  • Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.
  • Please include with your application at least three recent professional references (within the last five years).
  
  Benefits:
  The State of Utah offers eligible employees a variety of benefits including medical, dental, life and disability insurance, as well as a comprehensive leave program. Please click the following link for a detailed information page: To access a Total Compensation Calculator in Excel format click
  
  FMLA General Notice:
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  01
  
  Your answers to the questions on this posting must be supported by the duties, experience, andinformation listed in your profile's work and education history, not your resume. Please select "YES" to indicate you understand the validity of your claims will be based upon information contained within your application, not your resume. Unsubstantiated claims, exclusion of information, or incomplete answers may result in the disqualification of your application or of the question. Entering "see resume" will be considered an incomplete answer.
  • Yes
  
  02
  
  Please indicate how you heard about this specific job posting.
  • State of Utah job site (www.governmentjobs.com/careers/utah)
  • Referred by a Friend or Family
  • Indeed
  • Other External Job Board or Site
  • LinkedIn
  • Social Media (Facebook, Twitter, etc.)
  • DWS job website (www.jobs.utah.gov)
  • Advertisement (Digital Ad, Billboard, Print, etc.)
  • Professional Network (Association, Membership, Work Colleague)
  • University Network (Handshake, School Job Board, Career Center, etc.)
  • Contacted by a Recruiter
  • Career or Job Fair
  • Internship
  • Interviewed for different position
  • Internal communications (Agency/Division, etc.)
  • Other (not listed above)
  
  03
  
  In applying for this position, I understand that any offer of employment would be contingent upon me successfully completing a background screening as per the Utah Department of Health and Human Services Background Screening Policy and that my start date might change if the background check is not back by the original start date. . Link to the policy can be found in the job description.
  • Yes
  
  04
  
  Are you a current employee of the Utah Department of Health and Human Services (DHHS)?
  • Yes
  • No
  
  05
  
  Are you certified through either AHIMA or AAPC?
  • Yes
  • No
  
  06
  
  Please indicate your years of experience working under your certification.
  • No experience/certification
  • Less than 1 year
  • 1-2 years
  • 3-4 years
  • 5 or more years
  
  07
  
  Please briefly describe your experience working with either an AHIMA or AAPC certification.
  08
  
  Please indicate your years of professional experience working with Medicaid. Please note: being a recipient of Medicaid is not considered professional experience.
  • No experience
  • Less than 1 year
  • 1-2 years
  • 3-4 years
  • 5 or more years
  
  09
  
  Please briefly describe your work experience with Medicaid.
  10
  
  Please reate your level of healthcare program management experience.
  • No experience
  • Minimal experience
  • General experience
  • Extensive experience
  
  11
  
  Please briefly describe your experience with healthcare program management.
  12
  
  Please reate your level of experience with technicial writing.
  • No experience
  • Minimal experience
  • General experience
  • Extensive experience
  
  13
  
  Please briefly describe your experience with technical writing.
  Required Question

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