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Medical Policy Analyst (Remote Eligible)
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Job Description
- Req#: 744000068662977
Employer Industry: Health Insurance
Why consider this job opportunity:
- Opportunity for career advancement and growth within the organization
- Work remotely with the flexibility to choose your most productive environment
- Engage in meaningful work that contributes to the well-being of members
- Supportive and collaborative work environment with cross-functional teams
- Competitive benefits package that promotes work-life balance
What to Expect (Job Responsibilities):
- Research, analyze, and develop evidence-based medical policies for all products
- Collaborate with internal and external stakeholders in the medical policy development process
- Conduct comprehensive reviews of medical criteria and clinical practice guidelines
- Provide detailed analysis and recommendations for policy positions based on clinical literature
- Ensure compliance with regulatory and accreditation standards in medical policy content
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 and medical terminology
- Exceptional verbal and written communication skills for presenting complex information clearly
- Demonstrated ability to manage multiple priorities with strong attention to detail
How to Stand Out (Preferred Qualifications):
- Experience with medical policy analysis in a Blue Cross Blue Shield plan or other commercial health insurer
- Knowledge of utilization management and how medical criteria is applied
#HealthInsurance #MedicalPolicy #RemoteWork #CareerGrowth #EvidenceBasedHealthcare
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