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Medical Policy Jobs (NOW HIRING)

Point32Health

Director, Medical Policy

Canton, MA · On-site

Job Summary The Director, Medical Policy has responsibility for leading the organization's enterprise Medical Policy department activities. The Director leads, directs and modifies business processes ...

Caris Life Sciences

Director - Medical Policy

Position Summary The Director of Medical Policy will manage Market Access strategies for current and pipeline products and drive payer and health policy initiatives for the Caris Life Sciences ...

Cotiviti

Medical Policy Director

Overview The Medical Policy Director (MPD) is a key member of the Go To Market team. Along with the Client Engagement Leader, Client Medical Director (CMD), the MPD co-captains the team serving the ...

MIMEDX

Director, Health Policy

Marietta, GA · On-site

$195K - $235K/yr

Identify and monitor changes in medical policy, trends in the US Healthcare system, and regulations that impact providers; seek legal guidance and/or team input as applicable * Participate in market ...

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Medical Policy information

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$79.5K

$117.5K

$190K

How much do medical policy jobs pay per year?

As of Aug 12, 2026, the average yearly pay for medical policy in the United States is $117,469.00, according to ZipRecruiter salary data. Most workers in this role earn between $86,000.00 and $150,000.00 per year, depending on experience, location, and employer.

What are some common challenges faced by professionals working in medical policy development?

Professionals in medical policy often encounter challenges such as interpreting complex clinical evidence, balancing regulatory requirements with organizational goals, and addressing the diverse needs of stakeholders including clinicians, patients, and payers. They must also stay up-to-date with rapidly evolving medical technologies and guidelines, which can impact existing policies. Effective communication and collaboration across multidisciplinary teams are essential to ensure policies are evidence-based, practical, and aligned with both legal and ethical standards.

What is the difference between Medical Policy vs Medical Claims Specialist?

AspectMedical PolicyMedical Claims Specialist
Required credentialsTypically healthcare or insurance-related certifications, degrees in health administration or related fieldsLikewise, certifications in insurance processing or healthcare administration often preferred
Work environmentOffice settings, insurance companies, healthcare organizationsOffice environments, insurance companies, healthcare providers
Employer and industry usageUsed by insurance companies, healthcare organizations to develop coverage guidelinesUsed by insurance companies, healthcare providers to process and adjudicate claims

Medical Policy professionals focus on creating and managing coverage guidelines, while Medical Claims Specialists handle the processing and reimbursement of healthcare claims. Both roles are essential in the healthcare insurance industry but serve different functions within the claims and coverage process.

What is a medical policy?

A medical policy is a set of guidelines developed by health insurance companies or healthcare organizations to determine the medical necessity, appropriateness, and coverage of healthcare services and treatments. These policies help ensure that patients receive evidence-based care and that coverage decisions are consistent and fair. Medical policies are typically based on clinical research, expert consensus, and regulatory standards. They are regularly reviewed and updated to reflect advances in medical knowledge and changing healthcare regulations.

What are the key skills and qualifications needed to thrive in medical policy, and why are they important?

To thrive in Medical Policy, you need a strong understanding of healthcare regulations, clinical guidelines, and policy analysis, often supported by a degree in healthcare administration, public health, or a related field. Familiarity with data analysis tools, medical coding systems (such as ICD-10 or CPT), and healthcare compliance software is typically required. Excellent analytical thinking, communication, and collaboration skills help professionals interpret complex information and work with diverse stakeholders. These skills are crucial for ensuring that medical policies are evidence-based, regulatory compliant, and effectively support organizational and patient outcomes.
More about Medical Policy jobs
What cities are hiring for Medical Policy jobs? Cities with the most Medical Policy job openings:
What states have the most Medical Policy jobs? States with the most job openings for Medical Policy jobs include:
What job categories do people searching Medical Policy jobs look for? The top searched job categories for Medical Policy jobs are:
Medical Policy jobs near you
Infographic showing various Medical Policy job openings in the United States as of August 2026, with employment types broken down into 1% As Needed, 78% Full Time, 15% Part Time, and 6% Contract. Highlights an 96% Physical, 1% Hybrid, and 3% Remote job distribution, with an average salary of $117,469 per year, or $56.5 per hour.

Medical Policy Analyst

Utah Division of Human Resource Management

Salt Lake City, UT • On-site

$29.66 - $47.06/hr

Full-time, Part-time

This job post has expired today. Applications are no longer accepted.

Job description

Medical Policy Analyst
FT / PT Status - Full-Time
Salary - $29.66 - $47.06 Hourly Wage
Remote Work / In-Office - HybridRecruiter - Angie Rhodes arhodes@utah.gov
Application Deadline - 8/9/2026*
*This job posting may close at any time after the minimum advertising period of three (3) business days has passed, should a sufficient applicant pool be received. Applicants are encouraged to apply as early as possible.
Key Responsibilities
The Medical Policy Team resides within the Office of HealthcarePolicy and Authorization (OHPA) and is a dynamic and collaborative teamdedicated to shaping evidence-based healthcare coverage policies. OHPA lieswithin the Division of Integrated Healthcare (DIH) that plays a pivotal role indelivering essential healthcare services to eligible Utah residents. We overseecritical programs and focus on developing and implementing policies that ensurecomprehensive coverage, support a robust provider network, and fostercoordination across the healthcare continuum. Through rigorous policydevelopment, data-driven analysis, and collaborative partnerships, we strive tobuild a healthier Utah. Our work ensures that Medicaid members receivehigh-quality, appropriate care while adhering to complex regulatory frameworks.We foster an environment of continuous learning, mutual support, andaccountability.
Weare seeking an experienced and highly motivated Medical Policy Analyst to joinour team. This is a critical role that will drive the day-to-day development,analysis, and implementation of medical policies. This position offers a uniqueopportunity to directly impact healthcare quality and access within asupportive and forward-thinking environment.
The Medical Policy Analyst will focus on the execution and technical oversight of our policy functions, including:
  • Policy research and analysis
  • Coverage policy development and content
  • Policy implementation and operational coordination
  • Communication and stakeholder engagement
  • Project management and quality assurance

Supplemental Information
  • This position may currently be a hybrid of both in-office and remote work days. Please note, a position's eligibility for remote work is established by agency management and is subject to change at their discretion, at any time, and for any reason.
  • Effective July 1, 2021, State of Utah Employees must either reside in Utah or be in the process of relocating to Utah within 30 days of their start date.
  • Risks found in the typical office setting, which is adequately lighted, heated and ventilated, e.g., safe use of office equipment, avoiding trips and falls, observing fire regulations, etc.
  • Typically, the employee may sit comfortably to perform the work; however, there may be some walking; standing; bending; carrying light items; driving an automobile, etc. Special physical demands are not required to perform the work.

Qualifications
Possession of a nursing degree and a current, unrestricted license as a:
  • Registered Nurse (RN), or
  • Advanced Practice Registered Nurse (APRN)

Minimum of 5 years' experience as a
  • Registered Nurse (RN), or
  • Advanced Practice Registered Nurse (APRN)

About the Role
Location -
288 North 1460 West
Salt Lake City, Utah, 84116
United States
Background Check Required - You must successfully pass a criminal history check.
Drug Test Required - No
Schedule Code - B - Competitive Career Service
Why You Should Join Our TeamIn Utah, we believe hard work is important, but balance is essential. Finding work/life balance is a vital element to our culture. To find out more about WHY Utah, click here. Other benefits may include:
  • Job Stability: Enjoy the security and reliability of employment within a well-established organization.
  • Career Growth: Develop valuable skills and gain opportunities for leadership within a large organization.
  • Meaningful Work: Contribute to an important service that benefits the community and supports organizational goals.
  • Supportive Work Environment: Be part of a team that values cooperation, strong work ethics, and mutual support.

The AgencyFor more information on the Division of Integrated Healthcare, please visit our website.
EEO StatementThe State of Utah is committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity, or Veteran status. We also consider qualified applicants regardless of criminal histories, consistent with legal requirements. For accommodations, please contact (801) 957-9390.

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