A company is looking for a Manager, Policy Optimization to join their Clinical Policy team.
Key Responsibilities
Track policy performance and identify areas for process changes to enhance affordability and efficiency
Develop internal tracking systems to organize projects across timelines and deliverables
Create evidence-based recommendations for policy modifications and maintain industry best practices
Required Qualifications
Bachelor's degree in a relevant field (e.g., B.S.Pharm, PharmD, PA, NP, APRN, BSN, or RN)
Active, unrestricted clinical license
4+ years of experience with clinical policy, particularly in health insurance
4+ years of experience in utilization management and / or clinical operations
Working knowledge of medical and pharmacy coding and claims
Policy Manager • Pasadena, California, United States