Medical/Clinical Policy Writer (Work From Home)
Core
Research and develop moderate to complex Medical/Clinical, Behavioral Health (BH), and Reimbursement policies to ensure compliance with company, state, and federal guidelines.
Role type
Senior IC medical/clinical policy writer
Builds
Policy deliverables for Medicare, Medicaid, MyCare, D-SNP, Marketplace products, and other markets
Domain
Healthcare + Managed Care
Required skills
Medical terminology, claims payment policies, clinical expertise, healthcare administration, complex literature synthesis, policy development, regulatory compliance
Preferred skills
RN licensure, life sciences/healthcare advanced degree, clinical/managed care background, NCQA policy knowledge
Technologies
Microsoft Word, Excel, bibliographic software
Responsibilities
Monitor status reports for policy workflow, research clinical/scientific literature to inform policy, coordinate with subject matter experts on policy issues, track legislative/regulatory activities, create and update policy bibliographies
Seniority
Mid-level, hands-on IC