RN Clinical Program Senior Advisor - Work from Anywhere, USA

This position includes conducting research and analysis of published medical literature to respond to internal and external inquiries, as well as the development and maintenance of Cigna Medical Coverage Policies within the ICOG unit. This position requires identification of opportunities for Clinical Policy development and ability to conduct core clinical evidence reviews through the Healthcare Medical Assessment process. This position has significant interdisciplinary policy connections; the individual in this role must be comfortable, experienced and successful working in a team culture, as well as being able to take ownership of designated clinical policies.

Develops evidence-based medical coverage policies through analytic evaluation of published medical literature. Understands levels of evidence and can discuss the quality of a study to ensure coverage policies and medical inquiry responses transparently convey the strengths, weaknesses, and implications of published evidence. Presents new and revised coverage policies to a clinical audience in monthly Healthcare Medical Assessment Committee meetings. Effectively partners with medical policy team, manager, Medical Directors, clinical subject matter experts, and external vendors. Ensures that coverage policies are implemented, deployed to internet sites, and changes communicated within and outside the organization. Participates in special projects within the team as needed. Provides support as the coverage policy subject matter expert (SME) for the creation and maintenance of automation pathways.