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Clinical Policy Analyst/Writer (Remote)
Molina Healthcare • Remote • Posted 6 days ago
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Remote • Full-time • $49,430-$107,099/yr • Mid Level
Job Highlights
Using AI ⚡ to summarize the original job post
The Clinical Policy Analyst at Molina Healthcare reviews and evaluates existing clinical policies, proposes improvements, and researches new policies. This role involves creating reports, analyzing market trends, and improving department processes. The position requires proficiency in clinical policy, working knowledge of clinical policies, and an understanding of the managed care industry.
Responsibilities
- Reviews and evaluates existing clinical policies
- Proposes suggested improvements to existing clinical policies
- Researches new policies
- Creates reports
- Analyzes market trends
- Improves existing department processes
Qualifications
Required
- Proficiency in clinical policy through skills in literature searching and clinical research analysis
- Working knowledge of clinical policies
- Understanding of the managed care industry and market conditions
- High organizational and time-management skills
- Ability to work independently
- Excellent and clear written and verbal communication skills
- Strong analytical and problem-solving skills
- Ability to work in a cross-functional, professional environment
- Exceptional team player
- Ability to perform independent research on complex medical topics
Preferred
- Clinical experience in nursing, therapy, social work background
- Experience writing clinical policy
- Knowledge of NCQA regulations
About Molina Healthcare
Molina Healthcare is a Fortune 500 managed care company operating in the United States. They offer Medicaid, Medicare, and Marketplace health plans, focusing on providing affordable, quality healthcare to underserved populations. The company has expanded through acquisitions, such as acquiring Magellan Complete Care to enter the Florida market and enhance their services.
Full Job Description
**Job Summary**
The Analyst, Clinical Policy reviews and evaluating existing clinical policies, proposes suggested improvements to existing clinical policies, and researches new policies. Creates reports and analyzes market trends. Improves existing department processes.
**KNOWLEDGE/SKILLS/ABILITIES**
+ Proficiency in clinical policy through skills in literature searching and clinical research analysis based on the best available evidence or via direct work experience.
+ Working knowledge of clinical policies.
+ Understanding of the managed care industry and market conditions.
+ High organizational and time-management skills; ability to work independently.
+ Excellent and clear written and verbal communication skills.
+ Strong analytical and problem-solving skills.
+ Ability to work in a cross-functional, professional environment.
+ Exceptional team player with a strong ability to contribute positively to a team environment with a desire to learn, grow, and empower.
+ Ability to perform independent research on complex medical topics.
**JOB QUALIFICATIONS**
**Preferred Experience:**
+ Clinical experience, nursing, therapy, social work background
+ Experience writing clinical policy
+ Knowledge of NCQA regulations
**PHYSICAL DEMANDS:**
Working environment is generally favorable and lighting and temperature are adequate. Work is generally performed in an office environment in which there is only minimal exposure to unpleasant and/or hazardous working conditions. Must have the ability to sit for long periods. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential function.
To all current Molina employees: If you are interested in applying for this position, please apply through the intranet job listing.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Pay Range: $66,560 - $107,098.87 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
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