M&T Bank is hiring an RN Clinical Program Senior Advisor to join our Institute of Clinical Oversight and Guidance (ICOG). You will be responsible for developing and maintaining evidence-based medical coverage policies by analyzing published medical literature. This role serves as a coding and sourcing expert and is dedicated to improving the health and vitality of the communities we serve.
What You'll Do
- Develop evidence-based medical coverage policies through analytic evaluation of published medical literature.
- Act as a coding and sourcing expert for new or revised coverage policies.
- Present new and revised coverage policies to a clinical audience in monthly Healthcare Medical Assessment Committee meetings.
- Partner with the medical policy team, manager, Medical Directors, clinical subject matter experts, and external vendors.
- Ensure coverage policies are implemented, deployed to internet sites, and changes are communicated within and outside the organization.
- Provide support as the coverage policy subject matter expert (SME) for the creation and maintenance of automation pathways.
- Participate in special projects within the team as needed.
What We're Looking For
- RN required with an active unrestricted license in your state of residency.
- CPC Coding Certification required with a minimum of one year coding experience.
- Experience with evidence-based development processes and familiarity with US governing regulatory activity related to new product approvals.
- Understanding of medical coverage policies; three years or more experience working for a health plan.
- Excellent writing, communication and presentation skills.
- Prior experience with either clinical research or experience with writing (e.g., clinical papers, journal articles, training documents, SOP’s, technical writing, etc.).
- Ability to synthesize complex information and data into concise, understandable written responses.
- Ability to remain highly focused and organized in a fast-paced environment with frequent change and/or deadlines.
Nice to Have
- BSN preferred.
Team & Environment
You will work within the Institute of Clinical Oversight and Guidance (ICOG) unit, partnering with the medical policy team, manager, Medical Directors, clinical subject matter experts, and external vendors.
Benefits & Compensation
- Compensation: $116,200 - $193,600 USD per year.
- Comprehensive health-related benefits including medical, vision, dental, and well-being and behavioral health programs.
- 401(k) with company match.
- Company paid life insurance.
- Tuition reimbursement.
- Minimum of 18 days of paid time off per year and paid holidays.
Work Mode
This is a remote position open to candidates anywhere in the USA.
Qualified applicants will be considered without regard to race, color, age, disability, sex, childbirth (including pregnancy) or related medical conditions including but not limited to lactation, sexual orientation, gender identity or expression, veteran or military status, religion, national origin, ancestry, marital or familial status, genetic information, status with regard to public assistance, citizenship status or any other characteristic protected by applicable equal employment opportunity laws.
