The Senior Clinical Policy Research Professional works closely with Humana's dental directors and medical directors to research, develop and maintain dental and medical coverage policies utilizing an evidence-based medicine review process.
Requirements
- Research and develop dental and medical coverage policies utilizing a standardized checklist and an evidence-based medicine review process as well as utilizing CMS guidance
- Provide comprehensive verbal and written summation of research to dental directors, medical directors and leadership during policy discussion meetings and to the MCCR MCPA committees
- Perform ad hoc dental and medical research for dental directors and medical directors as needed for individual case reviews
- Perform research regarding new CPT and HCPCS codes as needed on a quarterly basis and work closely with the PAL team to address PAL codes requiring clinical coverage policy guidance
- Interdepartmental committee participation
- Collaboration with stakeholders across the organization
Benefits
- Medical benefits
- Dental benefits
- Vision benefits
- 401(k) retirement savings plan
- Time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave)
- Short-term and long-term disability
- Life insurance
