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Analyst, Clinical Policy
Molina Healthcare Job ID 2037977Essential Job Duties
• Reviews and evaluates existing clinical policies due for annual review.
• Determines any new evidence in areas related to existing policies including new technologies and pharmaceutical drugs.
• Proposes suggestions to improve existing clinical policies.
• Edits and amends existing policies, and write new policy drafts, including assistance with final quality checks to ready for approval.
• Assists with final quality checks on presentations, reports, or procedural document management.
• Liaises with internal and external stakeholders to determine needs and goals of clinical policies.
• Gathers data and produces reports related to clinical policy.
• Collaborates with certified coders to ensure proper coding of policies.
• Analyzes market trends and conditions for upcoming clinical policy needs.
• Participates in group projects related to clinical and payment policies including efforts to improve department processes.
Required Qualifications
• At least 4 years of related experience, including clinical and/or literature research analysis experience in the health care industry, or equivalent combination of relevant education and experience.
• Working knowledge of clinical policies.
• Understanding of the managed care industry and market conditions.
• Strong organizational and time-management skills; ability to work independently.
• Strong analytical and problem-solving skills.
• Ability to work in a cross-functional, professional environment.
• Exceptional team player with a strong ability to contribute positively to a team environment with a desire to learn, grow, and empower.
• Ability to perform independent research on complex medical topics.
• Excellent and clear written and verbal communication skills.
• Knowledge and ability to operate online platforms such as Microsoft Teams, etc.
• Microsoft Office suite and Adobe Acrobat proficiency.
Preferred Qualifications
• Clinical experience (i.e. nursing, therapy, and/or social work background).
• Experience writing clinical policy.
• Knowledge of National Committee for Quality Assurance (NCQA) regulations.
To all current Molina employees: If you are interested in applying for this position, please apply through the Internal Job Board.
Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V
Pay Range: $49,430.25 - $107,098.87 / ANNUAL
*Actual compensation may vary from posting based on geographic location, work experience, education and/or skill level.
About Us
Molina Healthcare is a nationwide fortune 500 organization with a mission to provide quality healthcare to people receiving government assistance. If you are seeking a meaningful opportunity in a team-oriented environment, come be a part of a highly engaged workforce dedicated to our mission. Bring your passion and talents and together we can make a difference in the lives of others. Molina Healthcare offers a competitive benefits and compensation package. Molina Healthcare is an Equal Opportunity Employer (EOE) M/F/D/V.
Job Type Full Time Posting Date 06/25/2026Job Alerts
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