Registered Nurse

Job Description:
Develop and maintain Medicare Medical Policies ensuring policies are approved implemented and placed in repository including annual reviews/updates
Collaboration with Medical Director on medical policy development and maintenance
Assist with the review of commercial medical policy meeting minutes to update Medicare Policies where needed
Supporting the preparation of policies and documents for Criteria Review Commitee and Utilization Management Committee Meetings
Research CPT or HCPCS codes as needed
Researching medical technologies as needed for specific cases requesting authorizations on technologies
Familiar with Microsoft Office products
Respond to inquiries from other teams.

Required Skills/Experience:
Experience in Medicare and managed care health insurance medical policy.
Strong written communication skills: ability to write clear and concise documents
Experience with collaborative projects
Research gather plan organize and evaluate information from multiple sources
Knowledge of CPT and HCPCS codes
Critical thinking and problem-solving skills
Clinical experience
Familiar with MS Office products

EEO Employer
LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race color sex religion sexual orientation national origin disability genetic information pregnancy or any other protected characteristic as outlined by federal state or local laws.
This policy applies to all employment practices within our organization including hiring recruiting promotion termination layoff recall leave of absence compensation benefits training and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications merit and business needs at the time.