We are seeking a detail-oriented and analytical Medical Policy Analyst to join our healthcare team. This role is crucial in developing, maintaining, and implementing medical policies that ensure high-quality patient care and regulatory compliance.
Key Responsibilities
Develop and maintain a comprehensive repository of medical policies, including conducting annual reviews and updates
Collaborate closely with the Medical Director on policy development and maintenance initiatives
Review JUMP meeting minutes and update Medicare Policies accordingly
Prepare and present policies and related documents for CRC and UMC meetings
Conduct research on CPT and HCPCS codes as needed for policy development and updates
Investigate emerging medical technologies to support authorization requests and policy decisions
Assist in ensuring all policies align with current CMS National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
Required Qualifications
Familiarity with CMS National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)
Strong analytical and research capabilities
Clinical background or education in a healthcare-related field
Preferred Qualifications
Experience in researching and writing healthcare policies
Knowledge of medical coding systems (ICD-10, CPT, HCPCS)
Familiarity with healthcare compliance regulations and standards