Medical Policy Analyst

You could be the one who changes everything for our 28 million members as a clinical professional on our Medical Management/Health Services team. Centene is a diversified, national organization offering competitive benefits including a fresh perspective on workplace flexibility.
 

***POSITION IS REMOTE***

Position Purpose:

• Designs, develops, and distributes evidence-based medical documents, including clinical practice guidelines, criteria sets, and technology assessments for inclusion into the "Guide for Evidence-Based Medicine.
• Researches topics utilizing medical texts and on-line medical literature.
• Presents draft document at the Health Net, Inc Medical Director Forum and the Health Net of California Medical Policy Committee.
• Investigates and responds to inquiries on medical topics requested by various groups; collects, trends and maintains outside independent review decisions regarding technology assessment and experimental/investigational services.
• Works closely with other departments to ensure dissemination of reliable and accurate medical information to physicians and members.
• Performs annual reviews of all medical policy documents.

Education/Experience: BSN, MSN or equivalent; Desire Masters degree in nursing, public health or health care administration or equivalent. Minimum three years experience in an acute care setting. Three years experience in the managed health care industry.

License/Certification: Must have and maintain current, valid and unrestricted RN or CPC license.

For Medical Affairs postings, current, valid and unrestricted RN and CPC licenses will be required

Pay Range: $68,700.00 - $123,700.00 per year

Centene offers a comprehensive benefits package including: competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules.  Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law.  Total compensation may also include additional forms of incentives.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

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