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Sr Clinical Policy Analyst
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Full-time
- The Sr Clinical Policy Analyst is responsible for promoting compliance and regulatory requirements within Healthfirst’s Clinical areas.
- The role supports several organizational governance committees, assists the Healthfirst Medical Directors and Utilization Management business units and aids with the development and oversight of clinical/medical policies.
- Duties/Responsibilities:Support the Medical Policy and Clinical Utilization Management (UM) Governance Committee Chairs, committee members, and related workgroups by organizing all meeting materials ( meeting minutes, presentations, etc.)
- Review the appropriate UM or related clinical and medical policies, job aids/procedures, and correspondence and make recommendations for policy creation/revision and/or committee actionEnsure parity in processes across clinical and medical departmentsConduct ad hoc medical condition research per Medical Director and/or UM Clinical Director requests.
- Collaborate with the Regulatory, Compliance, Legal and Clinical departments to ensure deliverables adhere to local, state, federal, and Healthfirst-specific compliance and regulatory guidelines.
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