Medical Research Conslt - First Coast

GuideWell Source • Remote, OH

9d • Remote

About The Position

Under limited direction, the Medical Research Consultant provides central research coordination for the Medical Affairs department, the primary clinical decision-support and medical policy-making organization within the Medicare Administrative Contractor. The position identifies, receives, tracks, reviews, analyzes, and recommends evidence for topics being considered for development or revision of a Local Coverage Determination (LCD) or other action by the Medical Policy team. It conducts comprehensive literature searches and reviews, synthesizes findings from diverse sources, and provides clear, actionable insights to support evidence-based decision-making.

The role supports LCD and other medical policy work through research, data assessment, collaboration, policy writing, and operationalization and training. It works with Medical Policy Nurses, Contractor Medical Directors, management, senior leadership, and interdisciplinary teams, and may perform other duties assigned by a supervisor. The position is open to remote work in the listed approved states; in-office and hybrid work may also be available in Florida and Pennsylvania, subject to further location approval.

Requirements

• Master's degree in Public Health, Epidemiology, Health Sciences, Data Science, or a related field.
• Demonstrated proficiency in MS Office applications.
• Demonstrated proficiency with systematic review software tools such as RevMan, DistillerSR, or Covidence.
• Demonstrated experience conducting systematic reviews and meta-analyses.
• Demonstrated experience and confidence leading large-group meetings.
• Demonstrated project management experience.
• Detail-oriented, with commitment to producing high-quality work.
• Excellent written and verbal communication skills.
• Excellent organization and tracking skills.
• Excellent collaboration skills and strong analytical and critical-thinking abilities.
• Ability to work independently and collaboratively in a team environment.
• Ability to work effectively with the Medical Policy team, including active participation in meetings, presentation of findings, and effective responses to questions.
• Must have access to a current and unrestricted REAL ID, U.S. Passport, U.S. Passport Card, Foreign Passport, or U.S. Permanent Residency Documents; Employment Authorization Cards are not substitutes for visas or U.S. Permanent Resident Cards.
• Selected applicants must clear pre-employment background investigation, drug screening, and identity-proofing documentation; continued employment is contingent on meeting applicable government customer screening and suitability requirements.
• The Federal Government and CMS may require applicants to have lived in the United States for at least three of the last five years; the years need not be consecutive.

Nice To Haves

• Two years of related experience.
• Knowledge of PRISMA guidelines.
• Experience with GRADE methodology.
• Familiarity with statistical software such as Stata or R.
• Medicare experience.
• Related health care industry experience.

Responsibilities

• Identify relevant research articles using databases such as PubMed, Cochrane, and Embase; screen titles, abstracts, and full-text articles against predefined criteria.
• Assist with developing and revising PICOT questions for each LCD project, complete evidence searches for Pricing requests, and support Medical Policy Nurses with LCD analysis from a research perspective.
• Extract relevant study data; review statistical data; assess study quality and risk of bias using standardized tools; and conduct meta-analyses or qualitative synthesis as appropriate.
• Compile unbiased findings into clear, concise, actionable reports with tables, figures, and appendices; create a synthesis workbook for each LCD project and an Evidence Review Table for each Contractor Advisory Committee topic.
• Incorporate GRADE methodology and perform risk-of-bias assessments.
• Collaborate with interdisciplinary teams and present findings and recommendations for consideration and discussion.
• Interact with Contractor Medical Directors, management, and the Medical Policy team; serve as a liaison in national workgroup meetings to support consistent research methodologies and coverage determinations between MACs.
• Serve as an internal point of contact and subject matter expert for research methodologies and related tasks, including for Contractor Medical Directors and senior leadership.
• Develop evidence summaries and analyses for LCDs to support coverage or noncoverage determinations; assist with determination language, review proposed and final LCDs, and recommend revisions.
• Collaborate with policy nurses on the evidence portion of LCD analyses.
• Keep current on systematic review methods, guidelines, and best practices; support and mentor junior staff or team members; and help standardize deliverables and the health technology assessment process.
• Perform other duties as deemed necessary by the supervisor.

Benefits

• Medical, dental, vision, life, and supplemental insurance plans effective the first day of the month following the date of hire.
• Short- and long-term disability benefits.
• 401(k) plan with company match and immediate vesting.
• Free telehealth benefits.
• Free gym memberships.
• Employee Incentive Plan.
• Employee Assistance Program.
• Rewards and Recognition Programs.
• Paid Time Off and Paid Sick Leave.

What This Job Offers

• Job Type: Full-time