Payment Policy Research Analyst

Sentara Health Administration, Inc.; Virginia Beach (VA); On-site; USD 106,000 - 163,000; Full time

Benefits offered by this job

Health insurance

401(k) match

Paid time off

Educational assistance

Bonus opportunities

Job summary

Sentara Health Administration, Inc. is seeking a Payment Policy Research Analyst & Technical Writer to identify, develop and present policy-related medical cost savings opportunities for Sentara Health Plan (SHP).

You will assess opportunities using data insights, policies, industry trends and SME input across SHP. You will collaborate with internal and external stakeholders to deliver savings through policy development and deployment.

Qualifications

• Strong research and analytical skills applied to policy opportunities.
• Experience presenting findings to stakeholders and leading discussions.
• Familiarity with healthcare reimbursement and cost-saving initiatives.

Responsibilities

• Research and assess internal payment policies to identify cost savings.
• Develop strategies to improve policies, criteria, and processes.
• Collaborate with stakeholders to deliver policy initiatives and publications.

Skills

Policy analysis

Stakeholder engagement

Data interpretation

Healthcare cost trends

Education

High School Diploma or equivalent

Bachelor's degree (Preferred)

Tools

Excel

PowerPoint

Outlook

Job description

City/StateVirginia Beach, VAWork ShiftFirst (Days)Overview:Payment Policy Research AnalystPayment 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 opportunitiesDetermine potential strategies &/or solutions to achieve identified cost savings such as policy development or enhancement, authorization criteria & process, contract strategy, claims editing & moreParticipate in analytical, investigative & other fact-finding work in support of opportunity developmentEstablish strong relationships with internal & external stakeholders to define, align & deliver payment initiatives & new/enhanced policy development in support of health plan goalsInfluence leadership to adopt new ideas, approaches &/or productsEducationHigh School Diploma or equivalent (Required)Bachelor Level Degree (Preferred)Certification/LicensureCertificate of Professional Coder- CPC Certification (Required)Experience3 years Health plan experience or 3 years Medical coding, required3 years Health plan claim auditing or appeals, preferredBS/BA/Advanced degree in health care or medical field preferredCPC required within first 6 months of hireRemote Work Schedule OpportunityQualified Candidates will possess:Experience presenting, collaborating & consulting with a variety of stakeholders or clients across multiple functional areasExperience managing multiple concurrent projects & meet tight delivery timelinesInnovative thinker that works well in an ambiguous, growth environmentIntermediate computer skills with Excel, PowerPoint & Outlook with minimal supervision:Excel - Create spreadsheets, manipulate data & create pivot tables/reportingPowerPoint - Create professional looking presentationsOutlook - Schedule meetings, coordination, task trackingPreferred:Knowledge of statistical methods used in the evaluation of healthcare claims dataProfessional & Institutional reimbursement experience includes coding certificationsReimbursement policy &/or technical writing experience for development & publicationWe provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $105,560.00 - $162,552.00 annually. Additional compensation may be available for this role, such as shift differentials, on-call pay, shift premiums, extra-shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full-time colleague working 2,080 hours annually. Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; 401(k)/403(b) with employer match; paid time off (vacation, sick time, and holidays); paid parental and military leave; educational assistance or student loan repayment; and voluntary benefits.Benefits: Caring For Your Family and Your Career• Medical, Dental, Vision plans• Adoption, Fertility and Surrogacy Reimbursement up to $10,000• Paid Time Off and Sick Leave• Paid Parental & Family Caregiver Leave• Emergency Backup Care• Long-Term, Short-Term Disability, and Critical Illness plans• Life Insurance• 401k/403B with Employer Match• Tuition Assistance – $5,250/year and discounted educational opportunities through Guild Education• Student Debt Pay Down – $10,000•Pet Insurance•Legal Resources Plan•Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.In support of our mission “to improve health every day,” this is a tobacco-free environment.For positions that are available as remote work, Sentara Health employs associates in the following states:Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, Washington, West Virginia, Wisconsin, and Wyoming.