Remote Clinical Analyst: Policy & Payment Intelligence

Lyric; Olympia (WA); Remote; USD 110,000 - 140,000; Full time

Job summary

Lyric, a leader in healthcare decision intelligence, is seeking a Clinical Analyst to develop clinical policies and payment solutions that enable fast, accurate coverage decisions. You will contribute to transparent, auditable rules and support health plans, providers, and laboratories.

Ideal candidates hold a relevant bachelor's degree and have hands-on experience in clinical content, data assets, and utilization management, with strong communication and analytical skills.

Qualifications

• Bachelor’s degree in biology, nursing, health sciences, or a related field.
• 5 years of direct patient care, clinical research, utilization management, payment integrity, revenue cycle management, clinical product development/program management, market access/medical science liaison, or medical writing.
• Proficiency with MS Word, MS Excel, and project management tools.
• Excellent verbal and written communication skills.
• Strong analytical abilities with qualitative and quantitative data.
• Familiarity with Excel formulas, sorting, filtering, and pivot tables, or willingness to learn.

Responsibilities

• Apply claims analytics to identify coverage criteria and claim edits.
• Identify and critically evaluate medical literature as part of evidence-based policy development.
• Draft, review, and maintain coverage criteria based on characteristics such as age, clinical presentation, and risk factors.
• Provide written and oral presentations to peers and leadership to obtain consensus on proposed criteria.
• Recommend and program rules/logic for denial of claims based on the criteria in written policies.
• Enter clinical content into internal tooling and databases; provide clinical content support to customers in collaboration with Customer Operations as needed.

Skills

MS Word

MS Excel

Project management tools

Excellent communication

Strong analytical skills

Pivot tables

Education

Bachelor’s degree in biology/nursing/health sciences or related field

Tools

JIRA

Monday.com

MS Project

Job description

Lyric, a leader in healthcare decision intelligence, is seeking a Clinical Analyst to develop clinical policies and payment solutions that enable fast, accurate coverage decisions. You will contribute to transparent, auditable rules and support health plans, providers, and laboratories.

Ideal candidates hold a relevant bachelor's degree and have hands-on experience in clinical content, data assets, and utilization management, with strong communication and analytical skills.