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Clinical Policy Development Analyst

Vaco LLC
  • Tampa, FL
  • Remote
    Today
    Vaco LLC

    Job Description

    Clinical Policy Development Analyst (Remote)

    About the Opportunity

    A growing healthcare technology organization is seeking a Clinical Policy Development Analyst to support the development of evidence-based clinical policies that guide coverage and reimbursement decisions across a large payer network. This role will focus on researching emerging diagnostic testing and healthcare trends, evaluating clinical evidence, and developing clear, actionable policy recommendations.

    This is a highly collaborative position that partners with clinical, product, coding, operational, and technical teams to ensure policies are translated into practical implementation strategies.

    Responsibilities

    • Research emerging diagnostic tests, laboratory services, clinical technologies, and healthcare trends.
    • Review and synthesize peer-reviewed literature, professional society guidelines, government coverage guidance, and other authoritative sources.
    • Evaluate clinical evidence and identify opportunities for new or enhanced coverage policies.
    • Draft, revise, and maintain clinical policies, including medical necessity criteria, coverage requirements, limitations, exclusions, and supporting references.
    • Present policy recommendations to clinical reviewers and incorporate feedback throughout the approval process.
    • Assess existing policies for accuracy, consistency, relevance, and opportunities for improvement.
    • Maintain organized documentation, research summaries, policy histories, and supporting rationale.
    • Collaborate with cross-functional stakeholders to ensure approved policies are implemented consistently and aligned with business objectives.
    • Utilize approved AI-assisted research and evidence-review tools while validating all findings against authoritative sources.
    • Manage multiple policy development projects in a fast-paced environment.

    Qualifications

    Required

    • Experience evaluating clinical literature and translating evidence into clear, actionable policy language.
    • Understanding of medical necessity criteria, healthcare coverage decisions, and payer policy development.
    • Strong analytical, research, writing, and documentation skills.
    • Ability to manage multiple projects and work effectively across cross-functional teams.
    • Experience developing, drafting, or maintaining clinical, medical, or coverage-related policies.

    Preferred

    • Advanced clinical, scientific, or healthcare-related degree or professional credential (RN, PA, NP, PharmD, PhD, etc.).
    • Experience within a health plan, managed care organization, utilization management organization, healthcare technology company, or related healthcare setting.
    • Knowledge of diagnostic testing, laboratory medicine, pathology, or related healthcare services.
    • Familiarity with commercial payer policies, Medicare coverage guidance, and healthcare coding concepts.
    • Experience leveraging claims data, healthcare analytics, or AI-assisted research tools to support policy development.

    What You'll Bring

    • Strong critical thinking and evidence-evaluation skills.
    • Ability to communicate complex clinical concepts in clear, concise written language.
    • Experience balancing clinical evidence, operational considerations, and business value.
    • Attention to detail and a commitment to producing high-quality work.
    • A collaborative approach and the ability to influence stakeholders across multiple disciplines.

    Location: Fully Remote (U.S.)

    Travel: Occasional travel for team meetings may be required.

    Compensation: Competitive base salary plus bonus opportunity.

    By submitting to this position, you are agreeing to be included in our talent pool for future hiring for similarly qualified positions.

    EEO Notice

    Vaco by Highspring is an Equal Opportunity Employer and does not discriminate against any employee or applicant for employment because of race (including but not limited to traits historically associated with race such as hair texture and hair style), color, sex (includes pregnancy or related conditions), religion or creed, national origin, citizenship, age, disability, status as a veteran, union membership, ethnicity, gender, gender identity, gender expression, sexual orientation, marital status, political affiliation, or any other protected characteristics as required by federal, state or local law.

    Vaco by Highspring and its parents, affiliates, and subsidiaries are committed to the full inclusion of all qualified individuals. As part of this commitment, Vaco by Highspring and its parents, affiliates, and subsidiaries will ensure that persons with disabilities are provided reasonable accommodations. If reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact

    HR@vaco.com

    .

    Vaco by Highspring also wants all applicants to know their rights that workplace discrimination is illegal.

    Representation Notice

    By submitting to this position, you agree that you will be giving Vaco by Highspring the exclusive right to present your as a candidate for the foregoing employment opportunity. You further agree that you have represented information about yourself accurately and have not affirmatively misrepresented your qualifications. You also agree to maintain as confidential, to the fullest extent permitted by law, any information you learn from Vaco by Highspring about the position and you will limit disclosure of information about the position only to the extent necessary to perform any obligations in furtherance of your application. In exchange, Vaco by Highspring agrees to exercise reasonable efforts to represent you through all solicitation, job screening and resume dispersal.

    For residents of Ontario, Canada: Based on Highspring’s discussions with its Client, Highspring’s understanding is that this position for employment is a current vacancy (either through Highspring as a contractor or with the client directly).

    Privacy Notice

    Vaco by Highspring and its parents, affiliates, and subsidiaries (“we,” “our,” or “Vaco by Highspring”) respects your privacy and are committed to providing transparent notice of our policies.

    • California residents may access Vaco by Highspring HR Notice at Collection for California Applicants and Employees here.
    • Virginia residents may access our state specific policies here.
    • Residents of all other states may access our policies here.
    • Canadian residents may access our policies in English here and in French here.
    • Residents of countries governed by GDPR may access our policies here.

    Additionally, submissions to this position are subject to the use of AI to perform preliminary candidate screenings, focused on ensuring minimum job requirements noted in the position are satisfied. More details about Vaco by Highspring’s use of AI can be found here (https://www.highspring.com/ai-use-notices/). Further assessment of candidates beyond this initial phase will be conducted by recruiters and hiring managers. Vaco by Highspring does not know and cannot opine on if its client’s use of AI products in hiring.

    Pay Transparency Notice

    Determining compensation for this role (and others) at Vaco by Highspring depends upon a wide array of factors including but not limited to:

    • the individual’s skill sets, experience and training;
    • licensure and certification requirements;
    • office location and other geographic considerations;
    • other business and organizational needs.

    With that said, as required by local law, Vaco by Highspring believes that the following salary range referenced above reasonably estimates the base compensation for an individual hired into this position in geographies that require salary range disclosure. The individual may also be eligible for discretionary bonuses.

    Numbers & Facts

    LocationTampa, FL (
    Remote
    )
    IndustryStaffing/Employment Agencies
    Company Size2,500 to 4,999 employees
    Year Founded2002
    Websitehttp://www.vaco.com/

    About Company

    Vaco provides expert consulting, permanent placement, executive search and strategic staffing for companies around the world, in the areas of accounting, finance, technology, healthcare, operations, administration and more. As a premier talent solutions firm, Vaco connects people to their dream jobs and helps leading companies find talent to grow their business. Since its founding in 2002, Vaco has grown to more than 35 offices across the globe, 700+ employees, more than 3,000 consultants and $450M in revenue. Vaco has been named to Inc. magazine’s list of the fastest-growing private companies for past 11 years and is dedicated to developing long-term relationships, life-long careers and creative client solutions.

    Skills

    • Analysis Skillsunmatched
    • Artificial Intelligence (AI)unmatched
    • Clinical Assessmentunmatched
    • Clinical Laboratoryunmatched
    • Communication Skillsunmatched
    • Cross-Functionalunmatched
    • Data Analysisunmatched
    • Detail Orientedunmatched
    • Documentationunmatched
    • Drug Developmentunmatched
    • English Languageunmatched
    • Governmentunmatched
    • Hair Stylingunmatched
    • Health Planunmatched
    • Healthcareunmatched
    • Managed Careunmatched
    • Medical Codingunmatched
    • Medical Productsunmatched
    • Medicareunmatched
    • Medicineunmatched
    • Multitaskingunmatched
    • Organizational Skillsunmatched
    • Pathologyunmatched
    • Policy Analysisunmatched
    • Policy Developmentunmatched
    • Policy Implementationunmatched
    • Project/Program Managementunmatched
    • Registered Nurse (RN)unmatched
    • Reimbursementunmatched
    • Sales Prospectingunmatched
    • State Laws and Regulationsunmatched
    • Team Playerunmatched
    • Test Labunmatched
    • Testingunmatched
    • Trend Analysisunmatched
    • Utilization Managementunmatched

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