Job Description

1. Revise and/or develop medical policies in conjunction with assigned medical director and in accordance with Development and Approval of Medical Policy administrative policy; process includes appropriate and timely implementation and publication.
2. Support MM sponsored meetings by preparing and distributing an agenda, minutes, and documents to be discussed, and taking minutes (meetings to include UMC, OMD, TEC, IRR, Policy Workgroup).
3. Assist with activities, which include internal audits, quality assurance control, quality improvement, provider satisfaction and departmental policies and procedures, to meet and/or maintain regulatory/accreditation/line of business requirements.
4. Research and respond to requests from internal departments/units requesting information on new technology (including research supporting TEC activities), medical procedures, drug therapies, DME, etc.
5. Serve as a resource to internal and external staff regarding issues relating to administrative policies and procedures, medical policies, and researching and resolving problems.
6. Conduct/schedule training opportunities and develop/present reports and various documentation related to MM activities.
7. Performs all other miscellaneous responsibilities and duties as assigned or directed.

Required

Preferred

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