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Medical Policy Analyst

North Carolina, United States, US•Posted Jul 7, 2023
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Company
Centene Corporation
Description
You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.


Position Purpose


  • Designs, develops, and distributes evidence-based medical documents, including clinical practice guidelines, criteria sets, and technology assessments for inclusion into the "Guide for Evidence-Based Medicine.
  • Researches topics utilizing medical texts and on-line medical literature.
  • Presents draft document at the Health Net, Inc Medical Director Forum and the Health Net of California Medical Policy Committee.
  • Investigates and responds to inquiries on medical topics requested by various groups; collects, trends and maintains outside independent review decisions regarding technology assessment and experimental/investigational services.
  • Works closely with other departments to ensure dissemination of reliable and accurate medical information to physicians and members.
  • Performs annual reviews of all medical policy documents.


Education/Experience BSN, MSN or equivalent; Desire Masters degree in nursing, public health or health care administration or equivalent. Minimum three years experience in an acute care setting. Three years experience in the managed health care industry. License/Certification Must have and maintain current, valid and unrestricted RN or CPC license. For Medical Affairs postings, current, valid and unrestricted RN and CPC licenses will be required


Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.


Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Identifier
3733fcd8e0f5bd3f7f4b64e03c802bb3
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