Senior Medical Policy Research Analyst

Department : Medical Policy Operations

Telecommuting Eligible : Yes

Job Grade : E12

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Job Title

Senior Medical Policy Research Analyst

Job Summary

The Senior Medical Policy Research Analyst is responsible and accountable for conducting research and generating systematic reviews and technology assessments on a range of new and evolving healthcare technologies, including devices, procedures, medical tests, and pharmaceuticals. Responsibilities include, but are not limited to, performing literature searches, gathering, and synthesizing data, analyzing evidence, writing reports, and contributing to policy development of Medicare Local Coverage Determinations, (LCDs) and Local Coverage Articles.

Essential Functions

Key Duties / Responsibilities / Accountabilities

• Conducts a comprehensive search of clinical literature on topics relevant to a proposed or existing Local Coverage Determinations (LCDs) within all appropriate electronic databases and internet resources, outline parameters of the database searches with special emphasis on keywords, cross-references, MESH headings, and selection criteria.
• Completes clinical literature analysis and writes a summary of evidence report using various software including Microsoft Office; organize and synthesize data, abstract data into evidence tables, and document clear and concise evidence-based recommendations.
• Compiles evidence and extracts, synthesizes, and summarizes information from a range of source documents such as regulatory reports, literature reviews, evidence synthesis reports, clinical studies, technology reports, and assessments.
• Collaborates with the Contractor Medical Director and other policy staff to determine the appropriate study selection criteria for inclusion in reports; select studies with the strongest study design, such as well controlled studies with clinically meaningful endpoints published in the peer-reviewed medical literature for analysis.
• Evaluates and documents the quality of clinical literature and the strength of evidence using generally accepted methodologies (e.g. GRADE).
• Documents within analysis reports Medicare program requirements supporting policy topic.
• Identifies, downloads, and maintains, through records that relate to the evidentiary review process including all decisions related to study selection.
• Participates in special projects assigned by leadership or management, as needed.
• Participates in policy enhancement and / or new policy development initiatives.
• Conducts presentations for internal staff or external stakeholders.
• Actively participates in workgroups, on conference calls, and attends conferences and public meetings to support meeting contractual requirements, as needed.
• Oversees the operational processes to support research tasks in support of proposed or existing LCDs.
• Develops processes and procedures to support LCD research and functions.
• Monitors tools and resources used for evidence review and recommends new tools or resources as needed.
• Leads special projects assigned by leadership or management, as needed.
• Coordinates efforts of additional staff and / or outside expert testimonials as an additional resource for conducting training or educational activities for internal staff or external stakeholders.
• Conducts quality assurance of research and evidence review processes.
• Provides direction, feedback, and guidance to Medical Policy Research team.

Non-Essential Duties and Functions

• Other duties as assigned
• Special projects as assigned.

Minimum Qualifications

• Bachelor's degree in Biostatistics, Life Sciences, Medical Sciences, Public Health, or closely related field as determined by Human Resources.
• 5 years' experience in biostatistics, healthcare, public health, Medicare, or closely related field
• 5 years' experience in conducting clinical research, medical evidence reviews, or closely related functions,

Experience requirements in the above 2 bullet points may be obtained simultaneously.

• Experience searching bibliographic and regulatory databases.
• Excellent analytical skills : ability to organize and evaluate complex clinical trial data and statistical analyses, and ability to summarize findings in a standardized report template.
• Skilled in performing comprehensive literature searches of all appropriate databases.
• Excellent writing skills including grammar and spelling.
• Excellent oral communication skills : ability to present findings or conduct presentations clearly and effectively.
• High attention to detail with focus on quality of work produced.
• Ability to work well independently and manage multiple projects ensuring deadlines are met.
• Ability to contribute in a team setting and collaborate with peers to complete projects timely.
• Proactive, effective communication and interpersonal skills necessary to collaborate in cross functional teams as well as to engage as part of a remote team.
• Outstanding organizational, prioritization, and time management skills to manage projects; works within budgets and schedules with flexibility and creatively mitigate risks.
• Exceptional proficiency with basic computer applications (specifically Microsoft Office); ability to manage files and work within a digital environment comfortably.
• Possesses familiarity of industry standards for evidence-based research methodology.

Preferred Qualifications

Above requirements and the following :

• Graduate level training (MS, MSc, MPH, PhD, ScD) or equivalent expertise in epidemiology, health sciences, nursing, pharmacology, or some other area of biological sciences applicable to clinical medicine.
• Experience with reference managers (e.g. EndNote).
• Experience with Medicare program related to requirements for policy development or relatable medical policy development experience with other health plans.
• Experience in performing technology assessments or systematic reviews and conducting health-related technology assessments.

Environment and Cognitive / Physical Demands

• Office Environment
• Ability to read, hear, speak, keyboard, reason, communicate effectively and problem solve
• Requires prolonged sitting and telephone use
• Requires the use of office equipment such as computer terminals, telephones, copiers, and printers
• Infrequent lifting to 15 pounds
• Infrequent stooping

Segregation of Duties

Every employee is responsible to perform their duties and responsibilities in accordance with Noridian values, policies and procedures, including but not limited to : Segregation of Duties Principles, HIPAA, Security and Privacy, CMS requirements, the Noridian Compliance Program and any other applicable laws, rules and regulations.

Statement of Other Duties

This document describes the essential functions, requirements, and responsibilities of this job, and is not intended to be a complete list of all tasks and functions. Employees may be requested to perform job related tasks other than those specifically listed in this description and may be required to perform any task requested by the supervisor or management.

Total Rewards Package :

Health, Dental and Vision Insurance, Voluntary Insurance Plans, Health Savings and Flexible Spending Accounts, 401k and Company Match, Company-paid Life Insurance, Education Assistance Program, Paid Sick Leave, Paid Holidays, Increasing PTO Accrual Plan, Medical / Parental / Disability Leave, Workers Compensation, Retiree Benefits, Employee Assistance Program, Financial and Health Wellness Benefits, Casual Dress, Open Office Setting, and Online Learning System.

CMS Access Compliance and Regulation Contingency Statement

Some positions require compliance with (i) federal and agency specific regulations and related clauses included in Noridian's prime contracts with the Government, (ii) background checks, and (iii) eligibility for a government-issued identification card.

An employee in this position may be required to possess a "Federal Identification Card" (Federal ID) as a condition of employment. Federal ID's may include one of the following : Personal Identity Verification (PIV) card, Personal Identity Verification-Interoperable (PIV-I) card, a Local-Based Physical Access Card issued by CMS, or a Local-Based Physical Access Card issued by another Federal agency and approved by CMS. Obtaining a Federal ID and continued eligibility for this position may require the successful completion of a Federal Background Investigation performed by the Federal Government and a residency requirement that you have lived in the United States at least three out of the last five years. Failure to obtain a Federal ID may result in the removal from the position or termination of employment.

Equal Employment Opportunity

Equal Opportunity Employer of Minorities, Females, Protected Veterans, and Individuals with Disabilities as well as Sexual Orientation or Gender Identity.

Below is the salary range for potential new hires.

Salary Range : $59,937.84 - $98,582.59

Other Compensation : Incentive Plan

Lifestyle Benefit : $50 / month

This job will be closed 1 / 24 / 2025 at 8 : 00AM CST. No further applications will be considered.

Equal Opportunity Employer / Protected Veterans / Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor's legal duty to furnish information. 41 CFR 60-1.35(c)

Salary : $59,938 - $98,583