Pharmacy - Senior Clinical Policy Specialist 146-2003
C+C
About this role
The Senior Clinical Policy Specialist is responsible for developing, maintaining, and ensuring compliance of medical necessity and prior authorization policies across various insurance products. They analyze clinical evidence and regulatory guidelines to support coverage decisions and collaborate with operational teams to align clinical policies with practice. The role requires deep knowledge of Medicare Advantage and other managed care policies.
Skills
Qualifications
About C+C
ccok.comCommunityCare is an Oklahoma-based health insurance provider offering Individual & Family coverage, Medicare plans (including Medicare Advantage), and employer Group plans. Their product lineup includes HMO and PPO options plus online enrollment, claims, and renewal resources. CommunityCare emphasizes local provider networks, member support tools, and care‑management resources to help members access care and manage costs.
About C+C
Headquarters
San Francisco, CA
Company Size
201-500 employees
Founded
2018
Industry
Technology
Glassdoor Rating
4.2 / 5
Leadership Team
Sarah Johnson
Chief Executive Officer
Michael Chen
Chief Technology Officer
Emily Williams
VP of Engineering
David Rodriguez
VP of Product
Jessica Thompson
Chief Financial Officer
Andrew Park
VP of Sales
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Salary
$150k – $180k
per year