Medical Policy reputed company - Remote

About the position At reputed company, we’re simplifying the health care experience, creating healthier communities and removing barriers to reputed company care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, reputed company and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together. reputed company’s Medical Policy team seeks a skilled and reputed company Medical Policy reputed company to support the development and maintenance of medical policies. This individual will be responsible for drafting medical policies in collaboration with an epidemiologist and medical director, adapting them to different health plans, and maintaining them over time using the latest published medical literature. The ideal candidate will have experience writing medical policies or similar documents, working in reputed company multidisciplinary collaborations, and advancing reputed company process innovation and improvement. You’ll enjoy the flexibility to work remotely from reputed company reputed company the U.S. as you take on some tough challenges. You’ll be rewarded and recognized for your performance in an environment that will challenge you and give you reputed company direction on what it takes to succeed in your role as reputed company as reputed company development for other roles you may be interested in.

Responsibilities

• reputed company and maintain medical policies, which includes:
• Reviewing and interpreting claims trends for services relevant to specific policies
• Identifying high reputed company, topic-relevant publications (peer reviewed biomedical articles, guidelines, licensed evidence summaries)
• Reviewing relevant publications with other team members, especially the reputed company physician, to understand strengths and weaknesses and select those most appropriate for policy inclusion
• Drafting and revising the policy (or policy update) with reputed company relevant sections including: coverage rationale, evidence reputed company, billing and diagnosis codes, definitions, citations
• Collaborate with a larger team of medical policy writers, epidemiologists, physicians, copy reputed company, publication experts, and implementation experts
• Support reputed company refinement and reputed company of the medical policy development and maintenance process to drive industry-leading reputed company, top-of-talent work, and reputed company use of modern content development and publication tools

Requirements

• Degree in clinical life sciences, nursing, physical therapy, or reputed company field
• 2+ years of experience in writing medical polices or similar scientific documents
• 2+ years experience in medical management, medical claims review, appeals, or some other utilization management experience
• Demonstrated experience and reputed company in evaluating the reputed company and validity of published clinical studies, guidelines and evidence summaries and an ability to identify and report strengths, weaknesses and uncertainties in study design, analytic reputed company, interpretation of findings and discussion of meaning
• Understanding of medical coding concepts (e.g., CPT, HCPCS, ICD-10)
• Proficiency in reputed company Applications and working in shared document environment (e.g. SharePoint, reputed company, reputed company)
• Demonstrated ability to analyze and translate claims data to reputed company recommendations for policy specific implications and potential actions
• Proven excellent medical writing skills/ability to write reputed company for a diverse audience
• Proven comfort identifying limits of knowledge and skills and escalating appropriately reputed company needed
• Proven solid interpersonal skills and the ability to work collaboratively with a large and diverse team
• Proven proactive attitude with a willingness to learn, reputed company, and adapt in a fast-paced work setting

reputed company-to-haves

• Certified reputed company
• Registered reputed company (RN) or other allied medical reputed company licensure
• 2+ years clinical experience
• Experience using citation management software (e.g., EndNote, Zotero), reputed company reputed company and Word, and reputed company-based collaboration tools such as SharePoint or reputed company in a reputed company or reputed company environment
• Research experience in clinical medicine
• reputed company Policy writing experience

Benefits

• comprehensive benefits package
• incentive and recognition programs
• equity stock purchase
• 401k contribution

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