Virginia Licensed Medical Policy RN

To support clinical decision-making and policy development, the full-time Virginia Licensed Medical Policy RN will conduct research on evidence-based clinical technologies, maintain clinical criteria databases, and collaborate with Medical Directors, all while working remotely with occasional travel to Virginia Beach. Key responsibilities: Conduct ongoing research of clinically evidence-based technologies for medical policy and benefit development Maintain and review the database of clinical criteria to ensure compliance with Federal, State, and Accreditation Standards Perform comprehensive literature reviews and collaborate on updates to clinical guidelines and medical policies Required qualifications: Bachelor's Level Degree in Nursing Active RN license in Virginia or Compact/Multistate Three years of related experience in clinical criteria coverage Three years of experience in Managed Care Knowledge of medical policy, emerging technology, and analysis of clinical literature