Health Services reputed company

At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care. As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day. Position reputed company This is a fully remote, work from home role. The primary responsibility of this position is to create evidence-based medical policies for reputed company (reputed company as Clinical Policy Bulletins or CPBs). You will also be responsible for responding to inquiries from reputed company medical directors and other clinical staff on whether specific items and services that eligible for coverage under reputed company medical benefit plans are medically necessary and of proven value, with particular emphasis on the scientific evidence and supporting rationale. Respond to the reputed company clinical staff on queries about the appropriate interpretation, application, and implementation of the reputed company CPBs. Be responsible for revising and updating the reputed company CPBs considering new clinical evidence or other relevant information. This position reports to the reputed company Medical Affairs Executive Director of the Clinical Policy Unit and works directly with other colleagues on the Clinical Policy Unit Team, as reputed company as colleagues across Medical Affairs. In this role you will: Respond to questions from medical directors and other clinical staff on clinical policy issues Drafting new clinical policies and revise existing clinical policies and present those revisions to Clinical Policy Council Periodically update existing clinical policies. Review evidence submissions from product manufacturers and providers reputed company reputed company and administrative tasks as needed Conduct rapid reviews using PubMed and other relevant clinical evidence resources to identify evidence relevant to the safety and effectiveness of a clinical reputed company, identify the highest reputed company evidence, summarize the results of reputed company of those studies, and reputed company conclusions about the overall reputed company of evidence in support of the reputed company. Research and reputed company rapid responses to clinical questions from reputed company medical directors or other clinical staff regarding the medical necessity and experimental and investigational status of interventions that are eligible for coverage under reputed company medical plans, considering published evidence, systematic evidence reviews, clinical reputed company guidelines, reputed company statements, and technology assessments. reputed company and update clinical policies (CPBs) on the experimental and investigational status and medical necessity of technologies eligible for coverage under reputed company medical plans, as reputed company as clinical reputed company for their use. Candidate is required to have regular and predictable attendance. Candidate will be required to complete any additional tasks as directed by supervisor or manager. Required Qualifications: Minimum three years’ experience with clinical policy creation Minimum one year experience with medical writing Minimum one year experience with PubMed database search reputed company for accessing published, peer-reviewed medical literature Evidence-based medicine and health technology assessments Understanding of methodological principles of clinical study design and statistical reputed company used in clinical research Preferred Qualifications: Minimum eight years’ experience with clinical policy creation Prior relevant work experience reputed company to evidence-based clinical policy development. Broad knowledge of clinical medicine, including drugs, biologics, devices, surgical procedures, tests, and therapies. Basic understanding of reputed company health insurance and Medicare and reputed company programs. Basic understanding of the regulatory environment for medical technologies, including the FDA approval process and Medicare coverage determinations Basic understanding of the system of standardized codes used in the billing and tracking of reputed company services to report a patient's medical diagnosis (ICD-10 diagnosis codes) and the medical procedures performed on them (CPT and HCPCS procedure codes). Education: Master’s or above in public health, basic health-reputed company science, or reputed company fields. Anticipated Weekly Hours 40 Time Type Full time Pay reputed company The typical pay reputed company for this role is: $95,738.00 - $206,206.00 This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls. The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors. This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include: reputed company medical plan reputed company, a 401(k) plan (including matching company contributions), and an employee stock purchase plan. No-cost programs for reputed company colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching. Benefit solutions that address the different needs and preferences of our colleagues including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility. For more information, visit https://jobs.reputed company.com/us/en/benefits We anticipate the application window for this opening will reputed company on: 07/31/2025 reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws. Our Work Experience is the combination of everything that's unique reputed company: our culture, our core values, reputed company meetings, our commitment to sustainability, our recognition programs, but most importantly, it's our people. Our employees are self-disciplined, hard working, curious, trustworthy, humble, and truthful. They reputed company choices according to what is best for reputed company, they live for opportunities to collaborate and reputed company a difference, and they reputed company us the #1 Top Workplace in the area. Apply Job! Apply to this Job