Payer Policy Coordinator & Cross-Functional Liaison

Akron Children’s Hospital; Akron (OH); Hybrid; USD 65,000 - 90,000; Full time

Job summary

Akron Children’s Hospital is seeking a Payer Policy Coordinator to oversee end‑to‑end payer policy review and communication, aligning clinical operations with payer requirements to support patient access and reimbursement accuracy. Hybrid work in Akron, OH with 2–3 days onsite.

The role collaborates with Payer Relations, Contracting, Revenue Cycle, Utilization Management and Legal to monitor policies, draft responses, and maintain a centralized policy repository.

Qualifications

• Bachelor's degree required; Healthcare Administration, Nursing, Health Information Management, or related field preferred.
• Minimum 3 years of progressive payer policy analysis or utilization management experience in hospital or health plan setting.
• Experience in a children's hospital or pediatric specialty environment is strongly preferred.

Responsibilities

• Monitor and maintain records of payer policies, provider manual updates, coverage determinations, and clinical guidelines.
• Analyze payer policy and regulatory changes for impact on patient access, reimbursement, and clinical operations.
• Coordinate internal reviews with clinical, pharmacy, operational, and subject‑matter experts; organize discussions and input.
• Draft and coordinate payer responses, comment letters, reconsideration requests, and appeals with Legal collaboration as needed.
• Maintain a centralized, searchable payer policy repository and notification process.
• Prepare concise policy summaries and impact analyses for leadership and departments.
• Provide policy analysis to support contract discussions and compliance monitoring.
• Assist in preparing payer performance materials (scorecards, JOC documentation).
• Participate in cross‑functional initiatives related to utilization management, revenue integrity, and value‑based care.

Skills

Excel proficiency

Policy interpretation

Analytical thinking

Cross-functional coordination

Documentation and reporting

Education

Bachelor's degree (Healthcare Admin/Health Info/Health Finance)

Tools

Payer provider portals

Policy tracking databases

Document management systems

Job description

Akron Children’s Hospital is seeking a Payer Policy Coordinator to oversee end‑to‑end payer policy review and communication, aligning clinical operations with payer requirements to support patient access and reimbursement accuracy. Hybrid work in Akron, OH with 2–3 days onsite.

The role collaborates with Payer Relations, Contracting, Revenue Cycle, Utilization Management and Legal to monitor policies, draft responses, and maintain a centralized policy repository.