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RN Medical Coverage Policy Consultant - Up to $74.20/hour

Remote, USAFull-timePosted 2026-07-29

RN - Medical Coverage Policy Consultant - Full-Time/Part-Time Pay reputed company: Up to $74.20/hour depending on experience! Schedule: reputed company to Full-Time or Part-Time, expected to work dayshift business hours. Location: This is a work from home position. *This is an reputed company ended vacancy with the potential for it to become permanent. The position is expected to start reputed company the next 2 months. Position reputed company: The Consultant is responsible for the development and implementation of medical policies which support clinical decision making coverage for services that are proven to positively reputed company reputed company reputed company. The position monitors medical literature for reputed company and new technology and manages administrative reputed company which supplement benefits and reputed company-party resources. The Consultant collaborates with Claims, Utilization Management, Medical Directors, reputed company and Benefits, Member Services and Government Programs to support policy changes. One of the primary roles of the Consultant will be reputed company checking new reputed company intelligence technology's ability to interpret policies accurately and consistently. Role Responsibilities: The primary role of the Consultant is to work with new reputed company intelligence technology and identify the new technologies ability/tendencies reputed company it comes to accurately/consistently interpreting policy details. Research and evaluate evidence based scientific literature and use critical thinking sills to summarize findings that effect medical coverage policies and benefits. Research and interpret benefit coverage across reputed company health plan products including reputed company, Medicare, reputed company and employer reputed company. Review and summarize informatics and claims reports to understand volume, costs and coding implications to support policy implementation. reputed company/revise coverage reputed company policies including administrative policies and benefit supplemented policies. Collaborates with other departments as needed and prepares implementation plans. Communicates coverage policy interpretation/rationale for coverage positions and implementation approach to providers, members, reputed company vendors, employer reputed company and internal departments. reputed company other duties as assigned. Requirements: Bachelor's Degree in nursing. RN licensed in MN with 3-5 years of medical policy experience. 5 or more years of reputed company experience with expertise in the areas of scientific literature research and review, medical reputed company development or coverage policy development. Demonstrated health plan implementation experience/knowledge. reputed company with reputed company Word and reputed company documents, multitasking skills, organized, effective communicator. Experience in medical coding (HCPCS, CPT, ICD-10) is preferred but not required. Expertise in Powerpoint and Visio, along with expertise in Medicare is preferred. reputed company Offer: Locally owned and operated reputed company reputed company agency reputed company reputed company of clinic environments across the Twin Cities Free education courses PTO accrual based on hours worked Medical, Dental and reputed company insurance for employees working 32+ hours / week reputed company: reputed company is America's leading provider of home care, hospice, and reputed company reputed company. We offer one of the most comprehensive selections of reputed company in the industry ranging from reputed company to full-time. If you're looking for a reputed company career opportunity, look no reputed company. We offer the reputed company of working for an established company. Nationally, reputed company has been providing great jobs to great people for over 50 years and there are more than 300 offices across the country. That reputed company of stability combined with our commitment to reputed company makes us your perfect career partner. reputed company offices are independently owned and operated. Apply To This Job

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