Medicaid Payment Policy Writer - Code Editing Manager Health Services
We’re building a world of health around every individual — shaping a more connected, convenient and compassionate health experience. At CVS Health®, you’ll be surrounded by passionate colleagues who care deeply, innovate with purpose, hold ourselves accountable and prioritize safety and quality in everything we do. Join us and be part of something bigger – helping to simplify health care one person, one family and one community at a time. Position Summary The Health Service Manager -Policy Writer for Medicaid is a key member of the Medical Policy & Program Solutions Team. The Medicaid Medical Coding Policy Writer is an individual contributor and will research and develop moderate to complex coding and payment policies; ensure adherence to company, state, and federal guidelines. In addition, this role will support the written communications shared with our state Medicaid Health Plans to complete the required State and Provider Notification communications. These activities enable Aetna Medicaid to improve health care quality services, and processes by partnering across business units to meet business needs and accomplish goals. This is a fully remote position. Eligible candidates may live anywhere in the contiguous United States.
Key Responsibilities
Ensures compliance with healthcare regulations and policies for state Medicaid and Duals line of business as it related to payment policies. Support the operational processes of the Medicaid Health Policy Governance Monitor status reports to ensure effective workflow and timely development of coding and payment policies Support internal departments and processes in the development and implementation of policies and procedures Ensure all medical policies are compliant with relevant regulations and are consistent across all lines of business Participate in department initiatives, scorable action items, and projects Work with health plan business leaders and corporate leaders to develop deliverables on policy priorities Provide medical coding and payment policies deliverables for Medicaid and Duals and other markets as business needs change Work with business product owners, government relations, and compliance leads to monitor legislative and regulatory activities for potential impact on existing or proposed policies Collaborate with interdisciplinary team members to achieve team goals Perform any other job duties as requested Required Qualifications 5 years relevant work experience 3 years of healthcare-related writing experience. Experience in writing payment policies for state specific Medicaid policy, Medicare policy writing a plus. 3 years of experience in medical policy development and/or implementation. Coding and managed care background. Effective communication skills, both verbal and written. Ability to multitask, prioritize and effectively adapt to a fast-paced changing environment. Proficiency with computer skills which includes navigating multiple systems and keyboarding. Strong presentation skills. Ability to travel up to 10% for meetings as needed.
Preferred Qualifications
Certified Professional Coder through AAPC or AHIMA (Physician, Inpatient, Outpatient or Payer), or Registered Health Information Technician (RHIT) Education Bachelor's degree preferred/specialized training/relevant professional qualification – or equivalent experience Anticipated Weekly Hours 40 Time Type Full time Pay Range The typical pay range for this role is: $60,300.00 - $132,600.00 This pay range represents the base hourly rate or base annual full-time salary for all positions in the job grade within which this position falls. The actual base salary offer will depend on a variety of factors including experience, education, geography and other relevant factors. This position is eligible for a CVS Health bonus, commission or short-term incentive program in addition to the base pay range listed above. Our people fuel our future. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong. Great benefits for great people We take pride in offering a comprehensive and competitive mix of pay and benefits that reflects our commitment to our colleagues and their families. This full‑time position is eligible for a comprehensive benefits package designed to support the physical, emotional, and financial well‑being of colleagues and their families. The benefits for this position include medical, dental, and vision coverage, paid time off, retirement savings options, wellness programs, and other resources, based on eligibility. Additional details about available benefits are provided during the application process and on Benefits Moments. We anticipate the application window for this opening will close on: 06/05/2026 Qualified applicants with arrest or conviction records will be considered for employment in accordance with all federal, state and local laws. Apply To This Job