Logistics: Palmetto GBA - one of BlueCross BlueShields South Carolina subsidiary companies.

Location: This position is full time (40 hours/week) MondayFriday 8:30 am to 5:00 pm and will be hybrid working on-site a minimum of three days per week at our 17 Technology Drive (GPC) location with up to two days remote after 90 days.

To work from home on remote days you must have high-speed (non-satellite) internet and a private secure home office.

Note: This position is contingent upon funding approval. We are actively recruiting in anticipation of funding which is expected to be confirmed imminently.

What Youll Do:

• Conducts health policy and quality standards research in support of DME (Durable Medical Equipment) prosthetic and orthotic post-payment review.
• Gather data and information to facilitate the review and overhaul of quality standards that influence Medicare local coverage policy development and decision-making.
• Recommends relevant evidence-based research to assist Medical Directors with quality standards modification and policy development based on best research practices.
• Work may extend to supporting JM/JJ jurisdiction policy development as needs evolve.
• Recommends resources for data/information. Analyzes available data/information monitors data/information quality and communicates findings related to quality standards and policy impact in reports presentations and communications to Medical Directors to facilitate their decision-making.
• Prepares documents presentations and other materials for leadership meetings with internal and external audiences.
• Assists with proofreading and article content development.

To Qualify for This Position Youll Need the Following:

• Required Education: Bachelors degree in a job-related field.
• Required Work Experience: Two years of demonstrated work experience in conducting documenting and presenting evidence-based research to support medical policies with a demonstrated ability to translate research findings into actionable outcomes or effectuate measurable changes.
• Required Skills and Abilities: Understanding of policy development. Knowledge of medical terminology. Ability to understand processes and present policy information to a high standard. Strong verbal and excellent written communication and human relations skills. Ability to research plan and gather data. Strong organizational skills necessary to schedule prioritize and complete work assignments.
• Required Software and Tools: Microsoft Office. Various research software products.

We Prefer That You Have the Following:

• Preferred Education: Masters degree in research public health healthcare or a related field. A graduate-level background in research methodology is strongly advantageous as this role requires the ability to conduct rigorous literature and policy research and translate findings into formal written reports and recommendations.
• Preferred Work Experience: Medicare DME prosthetic and orthotic experience strongly preferred. Five or more years of demonstrated work experience in conducting documenting and presenting evidence-based research to support medical policies with a verifiable track record of research that has influenced or effectuated policy or quality standards changes.
• Preferred Skills and Abilities: Statistical analysis. Strong writing and editing skills. Ability to be self-directed and work independently as well as working as part of a team.
• Preferred Software and Tools: Prior experience using PubMed GRADE and EndNote a plus.

Equal Employment Opportunity Statement

BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age race color national origin sex religion veteran status disability weight sexual orientation gender identity genetic information or any other legally protected status. Additionally as a federal contractor the company maintains affirmative action programs to promote employment opportunities for individuals with disabilitiesand protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal state and local laws and regulations.

We are committed to working with and providing reasonable accommodations to individuals with disabilities pregnant individuals individuals with pregnancy-related conditions and individuals needing accommodations for sincerely held religious beliefs provided that those accommodations do not impose an undue hardship on the Company.

If you need special assistance or an accommodation while seeking employment please email or call ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis.

We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Heres moreinformation.

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