Medical Policy Analyst

3 weeks ago


detroit, United States KYYBA Inc Full time

Title: Medical Policy Analyst

Location: Detroit, MI (100% REMOTE)

Duration 6+ months

About Role:

We are seeking a detail-oriented and analytical Medical Policy Analyst to join our healthcare team. This role is crucial in developing, maintaining, and implementing medical policies that ensure high-quality patient care and regulatory compliance.

Key Responsibilities

Develop and maintain a comprehensive repository of medical policies, including conducting annual reviews and updates

Collaborate closely with the Medical Director on policy development and maintenance initiatives

Review JUMP meeting minutes and update Medicare Policies accordingly

Prepare and present policies and related documents for CRC and UMC meetings

Conduct research on CPT and HCPCS codes as needed for policy development and updates

Investigate emerging medical technologies to support authorization requests and policy decisions

Assist in ensuring all policies align with current CMS National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)

Required Qualifications

Familiarity with CMS National Coverage Determinations (NCDs) and Local Coverage Determinations (LCDs)

Strong analytical and research capabilities

Clinical background or education in a healthcare-related field

Preferred Qualifications

Experience in researching and writing healthcare policies

Knowledge of medical coding systems (ICD-10, CPT, HCPCS)

Familiarity with healthcare compliance regulations and standards



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