02 Sep
Medical Policy Analyst Sr (United States) PS38240
North Carolina, Cary 00000 Cary USA

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


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