Job Description Summary

Develops (authors) evidence-based medical policy reviews to provide timely, clinical effectiveness information on medical technologies (i.e., procedures, devices, diagnostic tests, and drugs). Analyzes medical evidence and drafts medical policy, including complex analyses and evidence synthesis, for review by the BCBSA Medical Policy Panel (MPP-a panel comprised of Plan clinicians/medical directors) and in select cases review by the BCBSA Medical Advisory Panel (MAP-an external panel comprised of nationally recognized experts in technology assessment, clinical research and clinical practice).

Responsibilities include but are not limited to:

• Identify, critically appraise, and summarize scientific literature and clinical practice guidelines for medical technologies (procedures, devices, diagnostic tests and drugs). Perform thorough and objective analysis of the research design and validity of conclusions of current literature and unpublished data. Prepare clear, documented and defensible reports that summarize this information as evidence summary reports for presentation to the MPP and MAP. Provide technical expertise to facilitate the Panel's review processes.
  
• Contribute to the scientific quality, credibility and consistency of BCBSA Reference Medical Policies through participating in the peer review process and various learning activities (e.g., Learning Sessions, Journal Clubs, Medical Advisory Panel meetings, team meetings). Utilize expertise in designated clinical specialty to serve as resource to Medical Policy Services (MPS) staff and the MPP.
  
• Additional MPS project work contribution: Support MPS Leadership in managing/performing various MPP-related operations and other special projects as requested (e.g., Contribute to research needed for updating search strings, research on topics salient to the BCBSA external engagements and quality measure when requested, etc.)
  

Required Education, Certifications and Experience

• Masters Degree MPH, MHA, MS or equivalent in biomedical or biostatistical science or evaluation research.
  
• 5 years Research and/or clinical experience in researching, analyzing and presenting synthesis of clinical data
  
• Research and/or clinical experience in researching, analyzing and presenting synthesis of clinical data
  
• Demonstrated methodological skills in evaluation of research design, statistics or critical appraisal of clinical studies.
  
• Ability to work independently to generate, synthesize and analyze data, reports and tables.
  
• Technical proficiency with information technologies (e.g. Microsoft Office) and literature-searching.
  
• Excellent verbal and written communication skills, problem solving and organizational abilities.
  
• Demonstrated ability to manage multiple projects with overlapping timetables.
  
• Demonstrated presentation skills to facilitate the review and understanding of materials.
  
• Experience in working collaboratively with physicians, clinical investigators and research scientists.
  
• Ability to work effectively as a team member.
  

Preferred Education, Certifications and Experience

• PhD. PharmD.
  

People Management - No