Remote Medical Policy Writer: Clinical & Reimbursement

CareSource; Yorktown (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, behavioral health, and reimbursement policies in line with state and federal guidelines.

The role involves collaborating with health plan leaders and other stakeholders to deliver policy deliverables for Medicare, Medicaid, MyCare, D-SNP, Marketplace products, and other markets, with a virtual office setup and occasional travel.

Qualifications

• Bachelor's degree or equivalent required; advanced degree preferred in life sciences/healthcare.
• Minimum of 2 years healthcare-related writing experience preferred; clinical and managed care backgrounds preferred.
• Minimum of two years of experience in medical policy development and/or implementation preferred.

Responsibilities

• Support the operational processes of the Policy Governance Committee and ensure timely policy development.
• Monitor status reports to ensure effective workflow of medical and pharmacy policies.
• Develop and implement policies and procedures across departments; ensure regulatory compliance.
• Research clinical literature and guidelines to inform policy deliverables for Medicare, Medicaid and other markets.
• Collaborate with stakeholders to create policy bibliographies and deliverables.

Skills

Presentation skills

Analytical skills

Verbal & written communication

Problem solving

Organization

Interdisciplinary collaboration

Education

Bachelor's degree or equivalent

Advanced degree in life sciences/healthcare

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, behavioral health, and reimbursement policies in line with state and federal guidelines.

The role involves collaborating with health plan leaders and other stakeholders to deliver policy deliverables for Medicare, Medicaid, MyCare, D-SNP, Marketplace products, and other markets, with a virtual office setup and occasional travel.