Medical Policy Writer

Evolent • Baton Rouge, LA • 5d ago

Your Future Evolves Here

Evolent partners with health plans and providers to achieve better outcomes for people with most complex and costly health conditions. Working across specialties and primary care, we seek to connect the pieces of fragmented health care system and ensure people get the same level of care and compassion we would want for our loved ones.

Evolent employees enjoy work/life balance, the flexibility to suit their work to their lives, and autonomy they need to get things done. We believe that people do their best work when they're supported to live their best lives, and when they feel welcome to bring their whole selves to work. That's one reason why diversity and inclusion are core to our business.

Join Evolent for the mission. Stay for the culture.

What You'll Be Doing:

Put your passion where it meets purpose! We are looking for a Medical Policy Writer/Senior Policy Specialist who will be responsible for the development, approval, and maintenance of Utilization Management process documents to ensure compliance with legislative and accreditation requirements. This person will need to adhere to procedures, designated roles and responsibilities as outlined in the National Utilization Program Description.

Collaboration Opportunities:

Support and Development

Research, write, and edit UM Clinical Guidelines, through lifecycle of guideline

Collaborate with Clinical Subject Matter Experts to ensure accurate and evidence-based clinical content in Clinical Guidelines

Update clinical process documents as needed to ensure they meet the minimum standards for National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), and Company Policy across product lines and business segments

Tasked with problem solving and negotiation with internal and external customers around complex concepts and competing interests for risk mitigation

Research and incorporate customer and state regulatory requirements into Clinical Guidelines

Collaborate with multiple internal and external Key Stakeholders on the impact of Clinical Guideline changes

Oversee Clinical Guideline Committee, schedule and facilitate committee meetings, document meeting minutes, store all meeting content

Support the Medical Policy team on other projects and tasks

Qualifications - Required and Preferred:

Bachelor degree preferred but consideration for 4 or more years experience medical writing will be considered OR Master's Degree, PhD

Medical research and/or medical writing experience

Healthcare experience 2+ years

Ability to research, obtain, coordinate, and integrate feedback and directions from diverse operational groups and organizations into a written product

Analytical/problem solving skills

Strong interpersonal, consultation, organizational, tracking and follow-up skills

Possesses excellent verbal and written communication skills

Ability to work collaboratively with a team and with other Key Stakeholders

Ability to work independently with flexibility, and with ownership of assigned tasks

Preferred knowledge of legislative/oversight bodies [e.g., National Committee for Quality Assurance (NCQA), Utilization Review Accreditation Commission (URAC), Centers for Medicare and Medicaid Services (CMS)]

To comply with HIPAA security standards (45 C.F.R. sec. 164.308 (a) (3)), identity verification may be required as part of the application process. This is collected for compliance and security purposes and only reviewed if an applicant advances to the final interview state. Reasonable accommodations are available upon request.

Technical Requirements:

We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps and, specifically for all call center employees, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.

Evolent is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status. If you need reasonable accommodation to access the information provided on this website, please contact recruiting@evolent.com for further assistance.

The expected base salary/wage range for this position is $78,000-$84,000. This position is also eligible for a bonus component that would be dependent on pre-defined performance factors. As part of our total compensation package, Evolent is proud to offer comprehensive benefits (including health insurance benefits) to qualifying employees. All compensation determinations are based on the skills and experience required for the position and commensurate with experience of selected individuals, which may vary above and below the stated amounts.

Don't see the dream job you are looking for? Drop off your contact information and resume and we will reach out to you if we find the perfect fit!

Evolent

Go to Apply

Share this job

Similar Jobs

Physical Therapist- PRN - Outpatient - Baton Rouge

Ochsner Health • Baton Rouge, LA • 2d ago

Hospital & Medical

We've made a lot of progress since opening the doors in 1942, but one thing has never changed - our commitment to serve, heal, lead, educate, and innovate. We believe that every award earned, every record broken and ever...

2d ago

Go to Apply

Major & Strategic Account Executive - Hospital Software Solution Sales Remote

Wolters Kluwer • Baton Rouge, LA • 3d ago

Hospital & Medical

This is a remote position covering the New England territory Our solutions make a difference - and so do our people Clinical Decision Support and Provider Solutions (CDSP) - a market-leading, mission-driven business unit...

3d ago

Go to Apply

Respiratory Therapist - In House Agency - Baton Rouge

Ochsner Health • Baton Rouge, LA • 1w ago

Hospital & Medical

1w ago

Go to Apply

Datavant • Baton Rouge, LA • 1w ago

Hospital & Medical

Datavant is a data platform company and the world's leader in health data exchange. Our vision is that every healthcare decision is powered by the right data, at the right time, in the right format. Our platform is power...

1w ago

Go to Apply

Manager, Medical Economics

CVS Health • Baton Rouge, LA • 2w ago

Hospital & Medical

2w ago

Go to Apply

Subscribe to get new jobs sent directly to you
(no charge, cancel anytime)

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Similar Jobs

Physical Therapist- PRN - Outpatient - Baton Rouge

Major & Strategic Account Executive - Hospital Software Solution Sales *Remote*

Respiratory Therapist - In House Agency - Baton Rouge

RN-Endoscopy - Ochsner Medical Center Baton Rouge Endo - Full Time

Medical Claim Analyst

Physical Therapist Home Health

Per Diem Pharmacy Technician

Sr. Medical Analyst

Lead Health Information Specialist

Manager, Medical Economics

Major & Strategic Account Executive - Hospital Software Solution Sales Remote