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. To Qualify for This Position, You'll Need the Following: Required Education: Bachelor's degree in a job-related field. Required Work Experience: 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. Required Skills and Abilities: 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. Required Software and Tools: Microsoft Office. Various research software products. We Prefer That You Have the Following: Preferred Education: 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. Preferred Work Experience: 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. Preferred Skills and Abilities: Statistical analysis. Strong writing and editing skills. Ability to be self-directed and work independently as well as working as part of a team. Preferred Software and Tools: Prior experience using PubMed, GRADE, and EndNote a plus. Equal Employment Opportunity Statement BlueCross BlueShield of South Carolina and our subsidiary companies maintain a continuing policy of nondiscrimination in employment to promote employment opportunities for persons regardless of age, race, color, national origin, sex, religion, veteran status, disability, weight, sexual orientation, gender identity, genetic information or any other legally protected status. Additionally, as a federal contractor, the company maintains affirmative action programs to promote employment opportunities for individuals with disabilities and protected veterans. It is our policy to provide equal opportunities in all phases of the employment process and to comply with applicable federal, state and local laws and regulations. We are committed to working with and providing reasonable accommodations to individuals with disabilities, pregnant individuals, individuals with pregnancy-related conditions, and individuals needing accommodations for sincerely held religious beliefs, provided that those accommodations do not impose an undue hardship on the Company. If you need special assistance or an accommodation while seeking employment, please email
[email protected] or call 800-288-2227, ext. 47480 with the nature of your request. We will make a determination regarding your request for reasonable accommodation on a case-by-case basis. We participate in E-Verify and comply with the Pay Transparency Nondiscrimination Provision. We are an Equal Opportunity Employer. Here's more information. Some states have required notifications. Here's more information. If you don’t have an account with us and don’t see the dream job you are looking for, click on the link above to Join Our Talent Community by submitting your resume and contact information and we will reach out if we find a good fit. Welcome Here’s Your Smart Career Move Why should you join the BlueCross BlueShield of South Carolina family of companies? Other companies come and go, but for more than seven decades we’ve been part of the national landscape, with our roots firmly embedded in the South Carolina community. Business and political climates may change, but we’re stronger than ever. Our A.M. Best rating is A+ (Superior) — making us the only health insurance company in South Carolina with that rating. We’re the largest insurance company in South Carolina … and much more. We are one of the nation’s leading administrators of government contracts. We operate one of the most sophisticated data processing centers in the Southeast. We also have a diverse family of subsidiary companies that allows us to build on a variety of business strengths. We deliver outstanding service to our customers. If you are dedicated to the same philosophy, consider joining our team! Veterans Welcome! BlueCross is a strong supporter of our veterans, and many service men and women have joined our ranks. We’ve found the dedication, work ethic and job skills that serve well in the military excel in many of our lines of business, and we proudly have veterans filling positions in Human Resources, Information Technology, Customer Service, Operations, General Services and more. Through our government contracts, we also have employees serving at Shaw Air Force Base, the Naval Health Clinic in Charleston, the Naval Hospital in Beaufort and in our hometown of Columbia, S.C., at Ft. Jackson. If you are a full-time employee in the National Guard or Reserves, we will even cover the difference in your pay if you are called to active duty. Join Us If you're ready to join in a diverse company with secure, community roots and an innovative future, apply for a position now!