SUMMARY STATEMENT
Under limited direction, this position is responsible for providing central research coordination for the Medical Affairs department, which is the primary clinical decision-support and medical policy-making organization within the Medicare Administrative Contractor. Accountabilities include identification, receipt, tracking, review, analysis, and recommendation regarding evidence for topics under consideration for development or revision of a Local Coverage Determination (LCD) or other action by the Medical Policy team. Medical Research Consultants are responsible for conducting comprehensive literature searches and reviews to support evidence-based decision making within the organization. They play a crucial role in synthesizing research findings from diverse sources to provide clear and actionable insights.
ESSENTIAL RESPONSIBILITIES
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. This list of essential job functions is not exhaustive and may be supplemented as necessary.
Research: Literature analysis, health technology assessment
Conduct Comprehensive Literary Searches: (20%)
* Identify relevant research articles utilizing various databases such as PubMed, Cochrane, and Embase
* Screen titles, abstracts, and full-text articles for inclusion based on predefined criteria
* Assist with the development and revision of PICOT (patient, intervention, comparison, outcome, and time) questions for each LCD project.
* Completion of evidence searches for requests from Pricing.
* Assist Medical Policy Nurses with LCD analysis from a research perspective.
Data Assessment: (40%)
* Extract relevant data from included studies, ensuring accuracy and consistency
* Review statistical data, assess the quality and risk of bias in individual studies using standardized tools
* Perform meta-analyses or qualitative synthesis, as appropriate, to combine study findings
* Compile unbiased findings in clear, concise, and actionable reports, complete with tables, figures, and appendices.
* Creation of synthesis workbook for each LCD project.
* Creation of Evidence Review Table for each Contractor Advisory Committee topic.
* Incorporate GRADE methodology and perform risk of bias assessments.
Communication and Collaboration: (15%)
* Collaborate with interdisciplinary teams, actively presents findings and recommendations for consideration and discussion
* Routinely interacts with various levels of staff within the company, including the Contractor Medical Directors (CMDs), management, and routine communications with the Medical Policy team
* Serve as liaison during national workgroup meetings, representing the company and sharing information to ensure that research methodologies and coverage determinations are consistent between MACs.
* Serve as point of contact and SME for internal operations including the CMDs and senior leadership regarding research methodologies and related tasks.
Policy Writing: (20%)
* Development of summary and analysis of evidence for inclusion in LCDs to support coverage/noncoverage determinations.
* Active collaborator in the policy writing and determination process, assisting with coverage/non-coverage determination verbiage, review of proposed and final LCDs, and revision recommendations.
* Actively collaborates with the policy nurse to address the evidence portion of the LCD Analyses.
Operationalization and Training: (5%)
* Continually update knowledge of systematic review methods, guidelines, and best practices
* Provide support and mentorship to junior staff or team members on systematic review methodologies
* Contribute to standardizing deliverables (e.g., templates) and health technology assessment process
Performs other duties as the supervisor may, from time to time, deem necessary.
REQUIRED QUALIFICATIONS
* Master's in Public Health, Epidemiology, Health Sciences, Data Science, or a related field
* Demonstrated proficiency in MS Office applications
* Demonstrated proficiency in systematic review software tools (e.g., RevMan, DistillerSR, Covidence)
* Demonstrated experience conducting systematic reviews and meta-analyses
* Demonstrated experience and confidence leading a large group meeting
* Demonstrated project management experience
* Detail-oriented with a commitment to producing high-quality work
* Demonstrated excellent written and verbal communication
* Demonstrated excellent organization and tracking skills
* Demonstrated excellent collaboration ability
* Demonstrated strong analytical and critical thinking
* Demonstrated ability to work both independently and collaboratively in a team environment
* Ability to work effectively in a collaborative environment with the Medical Policy team including active participation in meetings, presentation of findings, and respond effectively to questions
PREFERRED QUALIFICATIONS
* Two years of related experience
* Knowledge of PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines
* Experience with GRADE (Grading of Recommendations, Assessment, Development, and Evaluations) methodology
* Familiarity with statistical software (e.g., Stata, R)
* Medicare experience
* Related health care industry experience
This opportunity is open to remote work in the following approved states: AL, AR, FL, GA, ID, IN, IO, KS, LA, MS, NE, NC, ND, OH, PA, SC, TN, TX, UT, WV, WI, WY. Specific counties and cities within these states may require further approval. In FL and PA in-office and hybrid work may also be available.
