Payment Policy Research Analyst - Remote (Select States)

Position Status: Full-time, Day Shift

Remote opportunities available in the following states: Virginia, North Carolina, Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Washington (state), West Virginia, Wisconsin, Wyoming

For those located in Washington State, the following salary range applies: $77,684.88 - $107,212.56.

Standard Working Hours: 8:00AM to 5:00PM (EST)

Minimum Requirements:

• 3 years Health plan experience or 3 years Medical coding, required

• 3 years Health plan claim auditing or appeals, preferred

• BS/BA/Advanced degree in health care or medical field preferred

• CPC required within first 6 months of hire

Required:

• Experience presenting, collaborating & consulting with a variety of stakeholders or clients across multiple functional areas

• Experience managing multiple concurrent projects & meet tight delivery timelines

• Innovative thinker that works well in an ambiguous, growth environment

• Intermediate computer skills with Excel, PowerPoint & Outlook with minimal supervision:

• Excel - Create spreadsheets, manipulate data & create pivot tables/reporting

• PowerPoint - Create professional looking presentations

• Outlook - Schedule meetings, coordination, task tracking

Preferred:

• Knowledge of statistical methods used in the evaluation of healthcare claims data

• Professional & Institutional reimbursement experience includes coding certifications

• Reimbursement policy &/or technical writing experience for development & publication

Position Overview:

Payment Policy Research Analyst & Technical Writer is responsible for the identification, development & presentation of new policy-related medical cost savings opportunities on behalf of Sentara Health Plan (SHP). You will assess new opportunities based on data insights leveraging tools, policies, industry trends & by soliciting input from subject matter experts across SHP. You will work with internal & external business constituents to determine opportunities for growth w/in our core payment/reimbursement policies & be responsible for savings delivery through deployment.

Primary Responsibilities:

• Research & assessment of internal payment policies & payment solutions in relation to competitors & industry standards to identify new cost savings opportunities

• Determine potential strategies &/or solutions to achieve identified cost savings such as policy development or enhancement, authorization criteria & process, contract strategy, claims editing & more

• Participate in analytical, investigative & other fact-finding work in support of opportunity development

• Establish strong relationships with internal & external stakeholders to define, align & deliver payment initiatives & new/enhanced policy development in support of health plan goals

• Influence leadership to adopt new ideas, approaches &/or products

Diversity and Inclusion at Sentara

Our vision is that everyone brings the strengths that come with diversity to work with them every day. When we are achieving our vision, we have team members that feel they belong and can be their authentic selves, and our workforce is reflective of the communities we serve.

We are realizing this vision through our Diversity and Inclusion strategy, which has three pillars: A diverse and talented workforce, an inclusive and supportive workplace, and outreach and engagement with our community. We have made remarkable strides in these areas over the past several years and, as our world continues to evolve, we know our work is never done.

Our strategies focus on both structural inclusion, which looks at our organizational structures, processes, and practices; as well as behavioral inclusion, which evaluates our mindsets, skillsets, and relationships. Together, these strategies are moving our organization forward in an environment that fosters a culture of mutual respect and belonging for all.

Please visit the link below to learn more about Sentara’s commitment to diversity and inclusion:

https://www.sentara.com/aboutus/mission-vision-and-values/diversity.aspx

Sentara Overview
For more than a decade, Modern Healthcare magazine has ranked Sentara Healthcare as one of the nation's top integrated healthcare systems. That's because we are dedicated to growth, innovation, and patient safety at more than 300 sites of care in Virginia and northeastern North Carolina, including 12 acute care hospitals.
Sentara Benefits
As the third-largest employer in Virginia, Sentara Healthcare was named by Forbes Magazine as one of America's best large employers. We offer a variety of amenities to our employees, including, but not limited to:

• Medical, Dental, and Vision Insurance

• Paid Annual Leave, Sick Leave

• Flexible Spending Accounts

• Retirement funds with matching contribution

• Supplemental insurance policies, including legal, Life Insurance and AD&D among others

• Work Perks program including discounted movie and theme park tickets among other great deals

• Opportunities for further advancement within our organization

Sentara employees strive to make our communities healthier places to live. We're setting the standard for medical excellence within a vibrant, creative, and highly productive workplace. For information about our employee benefits, please visit: Benefits - Sentara (sentaracareers.com)
Join our team! We are committed to quality healthcare, improving health every day, and provide the opportunity for training, development, and growth!

Note: Sentara Healthcare offers employees comprehensive health care and retirement benefits designed with you and your family's well-being in mind. Our benefits packages are designed to change with you by meeting your needs now and anticipating what comes next. You have a variety of options for medical, dental and vision insurance, life insurance, disability, and voluntary benefits as well as Paid Time Off in the form of sick time, vacation time and paid parental leave. Team Members have the opportunity to earn an annual flat amount Bonus payment if established system and employee eligibility criteria is met.