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Medical Policy Writer – Remote
2340730 At UnitedHealthcare, we’re simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the better. Come build the health care system of tomorrow, making it more responsive, affordable and optimized. Ready to make a difference? Join us to start Caring. Connecting. Growing together. UnitedHealthcare’s Medical Policy team seeks a skilled and experienced Medical Policy Writer to support the development and maintenance of medical policies. This individual will be responsible for drafting medical policies in collaboration with an epidemiologist and medical director, adapting them to different health plans, and maintaining them over time using the latest published medical literature. The ideal candidate will have experience writing medical policies or similar documents, working in close multidisciplinary collaborations, and advancing continuous process innovation and improvement. You’ll enjoy the flexibility to work remotely * from anywhere within the U.S. as you take on some tough challenges. Primary Responsibilities:
- Develop and maintain medical policies, which includes:
- Reviewing and interpreting claims trends for services relevant to specific policies
- Identifying high quality, topic-relevant publications (peer reviewed biomedical articles, guidelines, licensed evidence summaries)
- Reviewing relevant publications with other team members, especially the lead physician, to understand strengths and weaknesses and select those most appropriate for policy inclusion
- Drafting and revising the policy (or policy update) with all relevant sections including: coverage rationale, evidence summary, billing and diagnosis codes, definitions, citations
- Collaborate with a larger team of medical policy writers, epidemiologists, physicians, copy editor, publication experts, and implementation experts
- Support continuous refinement and evolution of the medical policy development and maintenance process to drive industry-leading quality, top-of-talent work, and optimal use of modern content development and publication tools
- Degree in clinical life sciences, nursing, physical therapy, or related field
- 2+ years of experience in writing medical polices or similar scientific documents
- 2+ years experience in medical management, medical claims review, appeals, or some other utilization management experience
- Demonstrated experience and skill in evaluating the quality and validity of published clinical studies, guidelines and evidence summaries and an ability to identify and report strengths, weaknesses and uncertainties in study design, analytic methods, interpretation of findings and discussion of meaning
- Understanding of medical coding concepts (e.g., CPT, HCPCS, ICD-10)
- Proficiency in Microsoft Applications and working in shared document environment (e.g. SharePoint, Box, Dropbox)
- Demonstrated ability to analyze and translate claims data to develop recommendations for policy specific implications and potential actions
- Proven excellent medical writing skills/ability to write clearly for a diverse audience
- Proven comfort identifying limits of knowledge and skills and escalating appropriately when needed
- Proven solid interpersonal skills and the ability to work collaboratively with a large and diverse team
- Proven proactive attitude with a willingness to learn, innovate, and adapt in a fast-paced work setting
- Certified Coder
- Registered Nurse (RN) or other allied medical professional licensure
- 2+ years clinical experience
- Experience using citation management software (e.g., EndNote, Zotero), Microsoft Excel and Word, and cloud-based collaboration tools such as SharePoint or Dropbox in a professional or academic environment
- Research experience in clinical medicine
- Healthcare Policy writing experience
