Senior Medical Policy Research Consultant

About Blue Cross and Blue Shield of Minnesota

At Blue Cross and Blue Shield of Minnesota, we are committed to paving the way for everyone to achieve their healthiest life. We are looking for dedicated and motivated individuals who share our vision of transforming healthcare.

As a member of the Medical Policy Team, the Senior Medical Policy Research Consultant is responsible for participating in the development of medical policy strategy and policy development. This position researches and analyzes medical literature, clinical practice guidelines, and federal and state coverage decisions to develop medical policies for BCBSM and our national business. The consultant also researches new technologies, reviews existing technologies, and presents findings to internal technology assessment groups, BCBSM committees, and external stakeholders when applicable.

• Develop medical policies for BCBSMN and ensure that changes in policy and supporting rationale are communicated to all lines of business, including Medicare, internal stakeholders, and others as needed.
• Present medical policy recommendations and supporting rationale to BCBSMN’s Medical and Behavioral Health Policy Committee, Coverage Committee (executive-level committee), and other key groups.
• Participate as a team member in internal BCBSMN technology assessment committees.
• Serve as an internal consultant to Medical Directors and staff on emerging medical technology issues.
• Serve as an external consultant to providers, vendors, manufacturers, government agencies, and other organizations on technology evaluation and medical policy processes.
• Participate in BCBSMN efforts to respond to regulatory and accreditation requirements (e.g., NCQA accreditation).
• Research and analyze scientific literature and medical policies in a clinical field to develop a strategic approach that integrates business considerations into the policy development process.
• Manage medical policy–related projects.

• 5+ years of related professional experience. All relevant experience, including work, education, transferable skills, and military experience, will be considered.
• Knowledge of medical literature and technology assessment evaluation methods.
• Demonstrated ability to analyze findings from current medical literature and develop written conclusions regarding medical technology assessment in terms of clinical effectiveness, measurable health outcomes, safety, and appropriateness.
• Knowledge of the local and national health care environment and trends.
• Ability to work independently and deliver defensible products to internal and external stakeholders.
• Effective communication of research results to multiple audiences, both verbally and in writing.
• Excellent interpersonal skills.
• Ability to build and maintain relationships with internal stakeholders, clinicians, regulatory agencies, and others.
• Project management experience.
• High school diploma (or equivalency) and legal authorization to work in the U.S.

• Bachelor’s or Master’s degree in a health‑related field with 5 years of experience in a health care environment (e.g., health care policy or clinical guidelines development).
• Knowledge of CPT and ICD‑9 coding helpful.

Hybrid

The hybrid approach balances flexibility with meaningful in‑person connection and collaboration. Teams meet in the office two days each week, often with at least one anchor day for team interaction. The rest of the week is earned remote work.

Pay Range: $90,800.00 – $ – $ annually. Pay is based on several factors, including skills, ability, and knowledge an applicant brings to the role.

Benefits may include: medical, dental, and vision insurance; life insurance; 401(k); paid time off (PTO); volunteer paid time off (VPTO); and more.

Blue Cross and Blue Shield of Minnesota is an Equal Opportunity Employer and maintains an affirmative action plan, as required by Minnesota law applicable to state contractors. All qualified applications will receive consideration for employment without regard to or discrimination based on any legally protected characteristic.

Individuals with a disability who need a reasonable accommodation in order to apply should contact talen