Health Services Professional - Remote

Overview

The primary responsibility of this position is to develop evidence-based medical policies for Aetna, known as Clinical Policy Bulletins (CPBs), and to support inquiries related to medical necessity and proven value of specific items and services.

In Short

• Develop evidence-based medical policies (CPBs).
• Respond to inquiries from medical directors and clinical staff.
• Address questions about CPB interpretation and application.
• Revise CPBs based on new clinical evidence.
• Collaborate with internal teams on policy alignment.
• Conduct literature searches and evaluate clinical studies.
• Maintain superior writing and communication skills.
• Manage time effectively and multitask.
• Assist with web publication of clinical policies.
• Participate in the development of AI tools for clinical policy.

Requirements

• Master’s degree in public health or related field.
• Strong understanding of evidence-based medicine.
• Knowledge of clinical study design and statistical methods.
• Experience with PubMed and peer-reviewed literature.
• Excellent verbal and written communication skills.
• Experience in technical writing on clinical topics.
• Ability to conduct rapid reviews of clinical evidence.
• Familiarity with health insurance and regulatory environments.
• Experience with Microsoft Office tools.
• Ability to work independently and meet deadlines.

Benefits

• Comprehensive medical plan options.
• 401(k) plan with company matching.
• Employee stock purchase plan.
• No-cost wellness programs and counseling services.
• Flexible work schedules and paid time off.
• Tuition assistance and family leave options.
• Financial coaching and dependent care resources.
• Retiree medical access for eligible employees.
• Supportive workplace culture focused on collaboration.
• Commitment to sustainability and employee recognition.