Avalon Healthcare Solutions is a healthcare company focused on diagnostic intelligence and evidence-based policy development for laboratory testing. The Clinical Policy Development Analyst will help expand the routine test management policy library by researching emerging laboratory tests, evaluating clinical evidence and coverage guidance, and drafting policies for review and approval.
This role is remote-eligible with quarterly travel required to the corporate office in Tampa, Florida. The position works closely with Product, Coding & Translation, Scientific Affairs, and claims-editing teams to support consistent policy implementation.
- Demonstrated ability to evaluate clinical literature and translate evidence into clear policy language.
- Familiarity with diagnostic testing, medical necessity, and health plan coverage policies.
- Strong research, analytical, writing, and documentation skills.
- Ability to manage multiple policy-development projects and collaborate across clinical, product, technical, and operational teams.
- Preferred: advanced clinical or scientific degree or relevant professional credential.
- Preferred: experience developing clinical policies for a health plan, laboratory benefit manager, utilization management organization, or healthcare technology company.
- Preferred: knowledge of routine laboratory testing, pathology, and diagnostic coding.
- Preferred: familiarity with CMS NCDs and LCDs, commercial payer policies, and professional society guidelines.
- Preferred: experience using claims data or AI-assisted research tools to identify and evaluate policy opportunities.
Location
Tampa, Florida, US
Employment Type
Full-time
Experience Level
Intermediate Level
Remote work allowed
Yes
Posted
1 month ago