Clinical Policy Analyst

Job Summary

Providing critical support for clinical policy review activities, the full-time Clinical Policy Analyst will evaluate existing policies, propose improvements, and conduct research for new policy creation to enhance member care quality and cost-effectiveness.

Key responsibilities

• Review and evaluate existing clinical policies due for annual review and propose improvements
• Conduct research on new evidence related to clinical policies, including technologies and pharmaceuticals
• Collaborate with stakeholders and contribute to group projects aimed at improving clinical and payment policies

Required qualifications

• At least 4 years of related experience in clinical and/or literature research analysis within the healthcare industry
• Working knowledge of clinical policies and understanding of the managed care industry
• Strong organizational skills and ability to work independently in a cross-functional environment
• Exceptional team player with a desire to learn and contribute positively to team dynamics
• Proficiency in Microsoft Office suite and online collaboration platforms