Remote Clinical Analyst - Medical Policy

Job Overview We are seeking a dedicated Medical Policy Clinical Analyst to join our dynamic team in a remote capacity. This vital role will involve evaluating and refining clinical policies, conducting research on emerging regulations, and ensuring strict adherence to Medicare/Medicaid compliance standards. As a recognized subject matter expert, you will provide valuable insights that support our organizational objectives. Key Responsibilities • Perform comprehensive analyses and research to interpret medical policy regulations, assuring compliance with industry benchmarks. • Collaborate in the creation of impactful, compliant policies that reflect your expertise in Medicare/Medicaid regulations and compliance principles. • Investigate and elucidate complex statutes and regulations, offering clear explanations related to organizational and procedural matters. • Uphold the Medical Policy Governance Process by ensuring compliance with policy development protocols. • Engage in team initiatives by sharing your insights and fostering collaborative efforts. • Facilitate effective communication of critical information across teams and departments, ensuring alignment with medical policy goals. Required Skills • Bachelor's Degree or equivalent experience. • Current, active CA Registered Nurse (RN) license, or an LVN with relevant experience. • AAPC (CPC) or AHIMA (CCS or CCS-P) certification is advantageous. • A minimum of 3 years' experience in medical coding (CPT, ICD-9, ICD-10). • At least 2 years of analytical experience within the healthcare sector. • In-depth understanding of Medicare health plans and regulatory compliance, particularly CMS Medicare/Medicaid regulations. • Proficiency in clinical policy development and the ability to conduct evidence-based research and analysis. • Strong communication and interpersonal capabilities to foster effective collaboration with cross-functional teams. • Skilled in Tableau and/or Alteryx, along with intermediate to advanced proficiency in Microsoft Office. • Excellent analytical and problem-solving skills, along with the capacity to adapt and excel in a fast-paced, evolving environment. Qualifications • Bachelor's Degree or equivalent experience in a related field.

Career Growth Opportunities

By joining our esteemed organization, you will have access to numerous avenues for professional development, empowering you to advance your career while positively impacting healthcare policy. Company Culture and Values We pride ourselves on fostering an inclusive and innovative work environment. Our commitment to diversity and integrity is integral to our mission, and we encourage all employees to contribute their unique perspectives.

Compensation

And Benefits • Competitive salary range: (80,300 to )128,500 per year. • Flexibility for remote work. • Annual employee bonus program. • Comprehensive wellness program to support your health and wellbeing. • Generous paid time off (PTO), including 11 paid holidays and additional floating holidays. • 401(k) retirement plan with employer matching and contributions. • Employee recognition program to celebrate your achievements. • Tuition reimbursement for your continued professional education. Ready to Join Us? We are continually looking for talented individuals who are passionate about enhancing healthcare policies. If you meet the qualifications and are enthusiastic about making a significant impact, we encourage you to apply today! Employment Type: Full-Time Apply Job!