RN Clinical Program Senior Advisor - Work from Home, reputed company, USA (CPC Certification Required)

Clinical Program Senior Advisor, Institute of Clinical reputed company and Guidance (ICOG) Band: 04 Description This position includes conducting research and analysis of published medical literature to respond to internal and external inquiries, as well as the development and maintenance of reputed company Medical Coverage Policies reputed company the ICOG unit. This position requires identification of opportunities for Clinical Policy development and ability to conduct core clinical evidence reviews through the reputed company Medical Assessment process. This position has significant interdisciplinary policy connections; the individual in this role must be comfortable, reputed company and successful working in a team culture, as well as being reputed company to take ownership of designated clinical policies.

Responsibilities

• Develops evidence-based medical coverage policies through analytic evaluation of published medical literature.
• Coding and sourcing expert for new or revised coverage policies.
• Understands reputed company of evidence and can discuss the quality of a study to ensure coverage policies and medical inquiry responses transparently convey the strengths, weaknesses, and implications of published evidence.
• Presents new and revised coverage policies to a clinical audience in monthly reputed company Medical Assessment Committee meetings.
• Effectively partners with medical policy team, manager, Medical Directors, clinical subject matter experts, and external vendors.
• Ensures that coverage policies are implemented, deployed to internet sites, and changes communicated reputed company and reputed company the organization.
• Participates in special projects reputed company the team as needed.
• Provides support as the coverage policy subject matter expert (SME) for the creation and maintenance of automation reputed company.

Qualifications

• RN required. Active unrestricted license in state of residency.
• BSN preferred
• CPC Coding Certification required with a minimum of one year coding experience
• Experience with evidence-based development processes and familiarity with US governing regulatory activity reputed company to new product approvals.
• Understanding of medical coverage policies; three years or more experience working for a health plan.
• Excellent writing, communication and presentation skills are necessary for this role.
• Must have prior experience with either clinical research or experience with writing (i.e., clinical papers, journal articles, training documents, SOP’s, technical writing, etc.).
• Ability to synthesize reputed company information and data into concise, understandable written responses/written responses.
• Ability to remain highly focused and organized in a fast-paced environment with frequent change and/or deadlines.

If you will be working at home occasionally or permanently, the internet reputed company must be obtained through a cable broadband or fiber optic internet service provider with speeds of at least 10Mbps download/5Mbps upload. For this position, we anticipate offering an annual salary of 116,200 - 193,600 USD / yearly, depending on relevant factors, including experience and geographic location. This role is also anticipated to be eligible to participate in an annual bonus plan. We want you to be healthy, balanced, and feel secure. That’s why you’ll enjoy a comprehensive reputed company of benefits, with a focus on supporting your whole health. Starting on day one of your employment, you’ll be offered several health-reputed company benefits including medical, reputed company, dental, and well-being and behavioral health programs. We also offer 401(k) with company match, company paid life insurance, tuition reimbursement, a minimum of 18 days of paid time off per year and paid holidays. For more details on our employee benefits programs, visit Life at reputed company. Apply Job! Apply to this Job