Remote Clinical Policy Writer – Medical & Reimbursement

CareSource; United States; A distancia; USD 72.000 - 116.000; Jornada completa

Descripción de la vacante

CareSource is seeking a Medical/Clinical Policy Writer to research and develop moderate to complex Medical/Clinical, BH, and Reimbursement policies, ensuring adherence to company, state, and federal guidelines. The role supports the Policy Governance Committee, monitors workflow, and collaborates with internal departments to develop compliant policies.

Responsibilities include literature review, policy bibliographies, and delivering policy work for Medicare, Medicaid, MyCare, D-SNP, and

Formación

• Bachelor’s degree or equivalent years of relevant work experience is required
• Advanced degree in life sciences/healthcare is preferred
• Minimum of two years healthcare-related writing experience preferred
• Minimum of two years of experience in medical policy development preferred
• Strong presentation skills

Responsabilidades

• 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 policy development and implementation
• Ensure all medical policies are compliant with relevant regulations and consistent across lines of business
• Participate in department initiatives and projects
• Research clinical literature and guidelines to create work products for team input and CPC
• Create and update policy bibliographies
• Work with health plan leaders and corporate teams to develop policy deliverables
• Provide policy deliverables for Medicare, Medicaid, MyCare, D-SNP, Marketplace and other markets
• Coordinate with subject matter experts to develop policy perspectives
• Monitor legislative activities for potential impact on policies
• Collaborate with interdisciplinary team members to achieve team goals
• Knowledge of NCQA policy timely requirements
• Perform other duties as requested

Descripción del empleo

CareSource is seeking a Medical/Clinical Policy Writer to research and develop moderate to complex Medical/Clinical, BH, and Reimbursement policies, ensuring adherence to company, state, and federal guidelines. The role supports the Policy Governance Committee, monitors workflow, and collaborates with internal departments to develop compliant policies.

Responsibilities include literature review, policy bibliographies, and delivering policy work for Medicare, Medicaid, MyCare, D-SNP, and