Registered Nurse

Job Description: • Develop and maintain Medicare Medical Policies ensuring policies are approved, implemented, and placed in repository, including annual reviews/updates • Collaboration with Medical Director on medical policy development and maintenance • Assist with the review of commercial medical policy meeting minutes to update Medicare Policies where needed • Supporting the preparation of policies and documents for Criteria Review Commitee and Utilization Management Committee Meetings • Research CPT or HCPCS codes as needed • Researching medical technologies as needed for specific cases requesting authorizations on technologies • Familiar with Microsoft Office products • Respond to inquiries from other teams. Required Skills/Experience: • Experience in Medicare and managed care health insurance medical policy. • Strong written communication skills: ability to write clear and concise documents • Experience with collaborative projects • Research, gather, plan, organize and evaluate information from multiple sources • Knowledge of CPT and HCPCS codes • Critical thinking and problem-solving skills • Clinical experience • Familiar with MS Office products EEO Employer LanceSoft is a certified Minority Business Enterprise (MBE) and an equal opportunity employer. We prohibit discrimination and harassment of any kind based on race, color, sex, religion, sexual orientation, national origin, disability, genetic information, pregnancy, or any other protected characteristic as outlined by federal, state, or local laws. This policy applies to all employment practices within our organization, including hiring, recruiting, promotion, termination, layoff, recall, leave of absence, compensation, benefits, training, and apprenticeship. LanceSoft makes hiring decisions based solely on qualifications, merit, and business needs at the time.

Created: 2026-03-04