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Medical Policy Analyst (Remote Eligible)
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Job Description
- Req#: 744000066693201
Employer Industry: Health Insurance
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Salary up to competitive market rates
- Work remotely anywhere within the continental U.S.
- Supportive and collaborative work environment
- Chance to make a positive impact on member care and health services
- Comprehensive training and development programs available
What to Expect (Job Responsibilities):
- Conduct research and analysis to develop and maintain evidence-based medical policies for all products
- Collaborate with internal and external stakeholders in the medical policy research and development process
- Interpret and summarize research findings for internal and external stakeholders
- Ensure medical policy content remains current with scientific evidence and clinical studies
- Provide oversight on medical policy coding guidance and recommendations
What is Required (Qualifications):
- Bachelor's degree in a health sciences-related field or completion of an accredited nursing program with an active RN license
- Minimum of 4 years of related health plan, research, or clinical experience
- Strong knowledge of commercial health insurer systems, medical terminology, and current healthcare issues
- Exceptional verbal and written communication skills, with the ability to present complex information clearly
- Strong organizational skills with attention to detail and the ability to manage multiple priorities
How to Stand Out (Preferred Qualifications):
- Direct medical policy analysis experience with Blue Cross Blue Shield or other commercial health insurers
- Knowledge of utilization management and medical criteria utilization
- Familiarity with Current Procedural Terminology (CPT) and International Classification of Diseases (ICD-10) coding
#HealthInsurance #MedicalPolicy #RemoteWork #CareerGrowth #EvidenceBasedCare
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