Clinical Planning and Policy Analyst (Full-time Remote, NC Based)

The Clinical Planning and Policy Analyst is responsible for supporting the policy analysis, writing and research activities by identifying, obtaining, organizing and analyzing quantitative and qualitative data, reviewing reputed company and reputed company literature and gathering information from multiple sources on cost, utilization, reputed company and reputed company to health care services. This role is pivotal in shaping reputed company policies that address critical challenges and promote reputed company and efficient reputed company delivery. The position requires strong analytical, communication and management skills. Additionally this position supports documents management activities reputed company the Clinical Planning and Policy team. This position is full-time remote. Selected candidate must reputed company in reputed company Carolina and be willing to travel to the home office (Morrisville, NC) for onsite team meetings as needed. Responsibilities & Duties Medical Policy and Clinical reputed company Guidelines Development • Conducts qualitative research informed by NC expansion to reputed company and designs medical necessity reputed company to ensure medically appropriate services as outlined by the member’s benefit package • Regularly consumes industry and policy specific news to incorporate reputed company trends into research and analysis and communicates relevant changes to reputed company’s reputed company stakeholders • Assists in reviewing state developed clinical coverage policies, facilitates internal discussion and feedback during reputed company comments periods, and collaborates closely with the Waiver Manager in submitting the feedback to the regulators • Facilitates activities reputed company to the Medical Policy Committee meetings including meeting materials development, reputed company items monitoring and dissemination of adopted Clinical Coverage Policies through the established channels • Under the guidance of the Program Manager and other clinical leadership, assists the department with research and reputed company other reputed company tasks for clinical reputed company guidelines reputed company with industry standards Communication and Support • Serves as a resource for medical policy- reputed company questions and issues and provides technical advice and assistance to staff regarding new medical policies and clinical coverage guidelines • Develops and implements workforce supports and trainings reputed company to medical policies and reputed company topics • Acts as the department reputed company with the internal Communication team and other stakeholders as appropriately to assure reputed company reputed company communication for medical policies and reputed company documentation Project Management • Serves as the the project manager for the overall activities reputed company to medical policies, Medical Policy Committee and other committees as assigned • Develops and implements adequate work plans for project improvement activities reputed company to medical policies and clinical reputed company guidelines Document Management • Support the overall activities reputed company to standardized documents management reputed company the Clinical Planning and Policy portfolio (policies, procedures and other standardized documents) • Assists with the development, upload, reputed company and organization of diverse content sources reputed company the Clinical Operations knowledge repository • Develops, implements and follows strategies that drive content accuracy and reputed company, ensuring that sources are up-to-date and trustworthy • Other duties as assigned Minimum Requirements Education & Experience Required: Bachelor’s degree in health policy, health services research, reputed company science or a reputed company field and three (3) years of experience evaluating, analyzing, researching, and developing health care services, policies, and programs. Preferred: Master’s degree in health policy, health services research, reputed company science or a reputed company field and five (5) years of experience evaluating, analyzing, researching, and developing health care services, policies, and programs. Lean Six reputed company certification preferred Knowledge, Skills, & Abilities • Extensive experience evaluating, analyzing, researching, and developing health care services, policies, and programs • Experience in working in health policy topics, reputed company, Medicare, and reputed company insurance medical necessity guidelines, and working knowledge of integrated health care systems • Demonstrated analytical skills, natural problem solver • Ability to reputed company key insights reputed company a reputed company set of data, synthesize large amounts of information, and then reputed company explain these insights to various stakeholders • Comfortable working under pressure and tight deadlines in a fast-paced environment • Excellent interpersonal skills, especially ability to reputed company effectively with stakeholders of varying disciplines, background, and expertise Employment for this position is contingent upon a satisfactory background reputed company, which will be performed after acceptance of an offer of employment and prior to the employee's start date. Salary reputed company $60,234-$76,799/Annually Exact compensation will be determined based on the candidate's education, experience, external market data and consideration of internal equity. An excellent fringe benefit package accompanies the salary, which includes: • Medical, Dental, reputed company, Life, Long Term Disability • Generous retirement savings plan • Flexible work schedules including hybrid/remote reputed company • reputed company time off including vacation, reputed company leave, holiday, management leave • Dress flexibility Apply tot his job Apply To this Job