Full-Time Medical Policy Analyst (Remote)

Bring your strengths to Wellmark as a Medical Policy Analyst!

About the Role: You will be responsible for the research, analysis, development, maintenance, coordination and documentation of medical policies for all products of Wellmark Inc. You will do this through evidence-based research and analysis of emerging and existing medical technologies and will contribute to ensuring Wellmark's members receive appropriate evidence-based healthcare services. You will achieve credibility by continuously improving research methodologies in the decision-making process to ensure Wellmark Medical Policies are grounded in evidence-based healthcare.

About You:

• Strong knowledge of commercial health insurer systems, medical terminology, and current healthcare issues.
• Ability to thoroughly research and comprehend large volumes of clinical literature and guidelines to draw clear, evidence-based conclusions and make concise policy recommendations.
• Strong communication skills (both written and verbal) to effectively convey complex and sometimes conflicting healthcare information to cross-functional teams.
• Excellent time management and organizational skills to manage multiple priorities with precision and attention to detail.
• Self-starter who thrives independently and collaboratively.

What you will do as a Medical Policy Analyst:

1. Keep up-to-date on industry knowledge, new treatments, and emerging technologies.
2. Conduct research using standard sources, the Internet, and peer-reviewed articles; analyze limitations and strength of evidence.
3. Collaborate with internal and external stakeholders.
4. Develop and maintain clear medical policies.
5. Provide detailed analysis, reports, and recommendations.
6. Ensure medical policy content is reviewed and updated annually.
7. Serve as a consultant and provide recommendations for policy implementation.
8. Comply with regulatory standards and internal guidelines.
9. Perform analytics review of utilization data and provide analysis.
10. Provide coding guidance and recommendations.
11. Mentor and counsel cross-functional peers on medical policies.
12. Other duties as assigned.

What is the last date for applying to the job?

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