North Carolina Clinical Policy Analyst

Job Summary

A company is looking for a Clinical Planning and Policy Analyst.

Key Responsibilities

• Conduct qualitative research and develop medical necessity criteria for Medicaid expansion
• Serve as a resource for medical policy-related questions and provide technical support
• Manage project activities related to medical policies and facilitate document management

Required Qualifications

• Bachelor's degree in health policy, health services research, social science, or a related field
• Three years of experience in evaluating, analyzing, researching, and developing health care services and policies
• Master's degree and five years of experience preferred
• Lean Six Sigma certification preferred
• Experience with Medicaid, Medicare, and commercial insurance medical necessity guidelines