Centene

Medical Policy Analyst

Posted on

February 12, 2025

Job Type

Full-Time

Role Type

License

RN

State License

Missouri

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Company Description

Job Description

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.

Requirements

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.

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Responsibilities

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.

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