Clinical Policy Writer – Remote, Policy Research

CareSource; Virginia Beach (VA); Remote; USD 72,000 - 116,000; Full time

Job summary

CareSource is seeking a Medical/Clinical Policy Writer to research and develop moderate to complex medical, clinical, behavioral health, and reimbursement policies in alignment with state and federal guidelines. You will support the Policy Governance Committee, monitor workflow, and collaborate with various departments to implement policies across lines of business while ensuring regulatory compliance.

The role requires strong analytical and writing skills and offers a virtual/remote work setup

Qualifications

• Bachelor’s degree or equivalent required.
• Advanced degree preferred in life sciences/healthcare.
• Minimum of two (2) years of healthcare-related writing experience preferred; clinical and managed care backgrounds preferred.
• Minimum of two (2) years of experience in medical policy development and/or implementation preferred.
• Strong presentation skills.

Responsibilities

• Support the operational processes of the Policy Governance Committee.
• Monitor status reports to ensure effective workflow and timely development of medical and pharmacy policies.
• Support internal departments and processes in the development and implementation of policies and procedures.
• Ensure all medical policies are compliant with relevant regulations and are consistent across all lines of business.
• Participate in department initiatives and projects.
• Research clinical and scientific literature and consensus guidelines to support policy work and bibliography creation.
• Collaborate with health plan leaders and external partners to develop deliverables on policy priorities.
• Provide policy deliverables for Medicare, Medicaid, MyCare, D-SNP, Marketplace products and other markets as needed.

Skills

Presentation skills

Verbal and written communication

Organization and tracking

Problem solving

Interpersonal / cross-functional

Healthcare knowledge

Analytical skills

Policy development

Education

Bachelor’s degree or equivalent

Advanced degree preferred

RN licensure preferred

Tools

Microsoft Word

Excel

Bibliographic software

Search engines

Job description

CareSource is seeking a Medical/Clinical Policy Writer to research and develop moderate to complex medical, clinical, behavioral health, and reimbursement policies in alignment with state and federal guidelines. You will support the Policy Governance Committee, monitor workflow, and collaborate with various departments to implement policies across lines of business while ensuring regulatory compliance.

The role requires strong analytical and writing skills and offers a virtual/remote work setup