Analyst, Health Policy Research (DME)

About the position

Summary

Gather and analyze data and information contained within articles, information systems, and other databases for evidence-based information related to health policies. Apply research findings to implement solutions that resolve complex issues. Present research findings to Medical Directors to facilitate their decision-making. Description Logistics: Palmetto GBA - one of BlueCross BlueShield's South Carolina subsidiary companies. Location: This position is full time (40 hours/week) Monday–Friday 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 You'll 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.

Responsibilities

• 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.

Requirements

• Bachelor's degree in a job-related field.
• 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.
• 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.
• Microsoft Office.
• Various research software products.

Nice-to-haves

• Master's 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.
• 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.
• Statistical analysis.
• Strong writing and editing skills.
• Ability to be self-directed and work independently as well as working as part of a team.
• Prior experience using PubMed, GRADE, and EndNote a plus.

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