Nurse/LPN Coding- Medical Policy Analyst
Highmark West Virginia - Charleston, WV

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Summary of Responsibilities:

The Medical Policy Analyst is responsible for the research, analysis, development, maintenance, coordination, and documentation of medical policy for all lines of business for Highmark and its affiliated companies that utilize Highmark Medical Policy. This includes the development and maintenance of policy for Highmark's Medicare Advantage products. The incumbent is accountable for coordinating and assuring that the appropriate OSCAR system changes are implemented in concert with policy changes. This position also responds to medical policy-related inquiries and Medical Director requests for evaluation of new technologies and/or new uses of existing technology that may or may not result in medical policy update activity. This position also works directly with the Professional Consultant Network that is comprised of approximately 250 professional providers that represent all professional specialties recognized by Highmark. This position requires the ability to multi-task, and be able to adapt to an ever changing environment. The incumbent must possess excellent writing, communication, and analytical skills, be flexible, as well as possess the ability to work independently. Both medical and operational backgrounds are preferred in addition to proficient computer skills.

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