Medical Policy Analyst Sr (United States) PS38240
Vacancy expired!
Description SHIFT: Day JobSCHEDULE: Full-timeYour Talent. Our Vision. At Anthem, Inc., it’s a
powerful combination, and the foundation upon which we’re creating greater access
to care for our members, greater value for our customers, and greater health
for our communities. Join us and together we will drive the future of health
care. This
is an exceptional opportunity to do innovative work that means more to you and
those we serve at one of America's leading health benefits companies and a
Fortune Top 50 Company.Location: United States and must
live within one (1) hour of an Anthem office.The Medical
Policy Analyst, Sr. is responsible for researching, drafting, and
maintaining Corporate medical polices and clinical UM guidelines ensuring the
use of valid and consistent research methodologies and the creation of
documents aligning with the most rigorous scientific evidence. Primary
duties may include, but are not limited to:
Conducting structured research of the peer-reviewed
literature and other resources within defined methodologies using
consistent templates, tools, and criteria to support:
Evaluation and assessment of potential
new topics for development into Anthem’s medical policy and clinical UM
guidelines
Maintenance of existing medical policies
clinical UM guidelines
Reviewing new and updated codes for appropriate
application within the policy and guideline framework
Working with key stakeholder to assess Enterprise need
for new and revised medical policies and clinical UM guidelines on new and
evolving topics
Collaborating across Enterprise-wide workgroups and
business units to facilitate proper implementation of medical policies and
clinical UM guidelines
Responding to internal and external inquiries that
warrant written clarification of a general or specific questions regarding
medical policy and clinical UM guideline issues
Coordination and collaboration with Anthem
subsidiaries on issues of mutual interest related to medical policy and
clinical UM guideline topics
Qualifications Qualifications:
Requires a BA/BS in a related field (Biology, Chemistry, Nursing, etc.) or a RN (having an Associate’s Degree or
higher)
5 years of related experience in Research in a science
related field.; or any combination of education and experience, which
would provide an equivalent background (i.e. Nursing, Clinical Research, Medical
Policy Research, basic science research, Public Health)
Clinical or medical policy research experience is
required
Working knowledge of medical coding required
Nursing degree, MPH, or equivalent preferred
Experience and familiarity with genetics and genetic
testing desired
Anthem, Inc. is ranked as one
of America’s Most Admired Companies among health insurers by Fortune magazine
and is a 2018 Diversity Inc magazine Top 50 Company for Diversity. To learn
more about our company and apply, please visit us at careers.antheminc.com. An
Equal Opportunity Employer/Disability/Veteran.REQNUMBER: PS38240
Vacancy expired!