Analyst, Payer Advocacy & Value Solutions

American College of Cardiology; Washington (District of Columbia); On-site; USD 75,000 - 95,000; Full time

Benefits offered by this job

Generous paid time off

Tuition assistance

10% retirement contribution

Job summary

The American College of Cardiology in Washington, DC is seeking a qualified individual to join their Payer and Care Delivery Policy team. This role emphasizes collaboration with health plans and advocating for performance measures that affect cardiovascular practice. Candidates should have significant experience in project management and a bachelor's degree in public or health policy.

Benefits include world-class insurance options, generous paid time off, tuition assistance, and a 10% retirement contribution after a year of service. The ACC values work-life balance for its employees.

Qualifications

• 5+ years of progressive project-management experience in physician reimbursement or provider relations.
• Ability to work on multiple complex assignments independently and as part of a team.
• Excellent oral and written communication skills.

Responsibilities

• Develop and maximize health plan relationships to facilitate collaborative problem‑solving.
• Lead the coordination of responses to payer requests regarding coverage and reimbursement.
• Solicit and review private‑payer cardiovascular medical policies.

Skills

Project management

Communication skills

Organizational skills

Knowledge of managed care

Time management

Education

Bachelor’s degree in public policy or health policy

Job description

Job Description

The Payer and Care Delivery Policy (PCDP) team in the Advocacy Division of ACC helps ACC members succeed in a value‑based payment environment. The team’s four primary functions are:

• Provide value‑based payment surveillance and policy expertise to facilitate member participation in alternative payment models and to anticipate and communicate opportunities and threats associated with payment reform initiatives.
• Advocate for performance measures, including tracking and influencing activities of quality organizations such as Battelle’s Partnership for Quality Measurement to keep ACC‑stewarded measures in the Quality Payment Program (CMS) and as preferred measures for private payers through initiatives such as the Core Quality Measure Collaborative.
• Manage private payer relationships and lead ACC’s strategic direction in this area.
• Manage the activities of the Population Health Management Work Group and Partners in Quality Subcommittee to advance ACC strategic plan goals.

Responsibilities

• Develop and maximize health plan relationships to facilitate collaborative problem‑solving and conflict resolution.
• Lead the coordination of the College’s response to specific member or payer requests, including coverage, reimbursement, prior authorization, and access.
• Solicit and review private‑payer cardiovascular medical policies; track and assess acceptance of ACC feedback in health plan medical policy and organize strategy to address controversial policies.
• Develop policy engagement and advocacy opportunities for Medicare Advantage and CV‑related pharmacy benefit plans.
• Collaborate with CV subspecialty societies and state chapter leadership on reimbursement and policy issues to unify the voice of the cardiovascular community when feasible.
• Develop relevant content and materials to inform and influence leadership, members, or external audiences regarding current or emerging topics germane to the strategic or business objectives of the department or division.
• Assist member committees including Health Affairs Committee, Population Health Management WG, and Partners in Quality Subcommittee.
• Facilitate communication and collaboration within and across the College to align efforts.
• Participate as a member of cross‑functional teams to support department activities.
• Other responsibilities as assigned.

Qualifications

• Bachelor’s degree or equivalent experience in public policy, health policy, or a related field.
• At least five years progressive project‑management experience in physician reimbursement or provider relations; an advanced degree may substitute for work experience.
• Substantial knowledge of managed care operations and policy and payment reform in public and private payer systems.
• Ability to work on multiple complex assignments independently and as part of a team.
• Ability to provide expertise and guidance for work teams as appropriate.
• Excellent organizational skills and attention to detail.
• Excellent time‑management skills and ability to work well under strict deadlines.
• Excellent oral and written communication skills.
• Desire and ability to learn new skills.
• Ability to travel (5–10%).

Desired Qualifications

• Experience working for or with a medical association.
• Experience with private payer, Medicare, and regulatory issues affecting cardiovascular practice.
• Familiarity with physician payment, value‑based care initiatives, and physician and patient quality measurement.

Benefits

ACC values all members of our College family. Staff enjoy world‑class benefits and a culture of work‑life balance, including insurance (medical, dental, vision, basic life, short‑ and long‑term disability, and supplemental options); generous paid time off (pre‑loaded vacation and sick, 12 holidays and an organizational shutdown during the last week of the year, parental leave, two community service days, and half‑day summer Fridays); tuition assistance; a 10% retirement contribution after a year of service; and more. Offerings may change at any time.

Salary

Salary ranges will vary based on the local labor market. ACC’s Recruitment Team can provide more information to candidates during initial discussions.

EEO Statement

ACC is proud to be an equal‑opportunity and affirmative action employer. We celebrate diversity and are committed to creating an inclusive environment for all candidates and employees. All employment is decided on the basis of qualifications, merit, and business need. Equal‑Opportunity Employer, including individuals with disabilities and veterans. ACC is committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans in our job application procedures. If you need assistance or an accommodation due to a disability, you may contact Katie Sarreal, HR Business Partner at [e-mail] or [phone].