Policy & Cost-Savings Research Analyst (Remote)

Sentara Health; Maryland City (MD); Remote; USD 106,000 - 163,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

401k/403B with employer match

Paid Time Off and holidays

Tuition Assistance

Job summary

Sentara Health is seeking a Payment Policy Research Analyst to identify and present cost-saving opportunities in policy-related medical costs for Sentara Health Plan. The role involves data-driven analysis, collaboration with subject matter experts, and delivering measurable savings through policy and process improvements.

Responsibilities include researching internal payment policies, developing strategies, and presenting findings to stakeholders.

Qualifications

• High School Diploma or equivalent required.
• Bachelor level degree preferred.
• CPC Certification required within first 6 months of hire.
• 3 years health plan experience or 3 years medical coding required.
• 3 years health plan claim auditing or appeals preferred.
• Remote work schedule opportunity.

Responsibilities

• Research and assess internal payment policies and payment solutions to identify new cost savings opportunities.
• Determine potential strategies or solutions to achieve identified cost savings such as policy development or enhancement, authorization criteria and processes, contract strategy, claims editing, or more.
• Participate in analytical, investigative and other fact-finding work in support of opportunity development.
• Establish strong relationships with internal and external stakeholders to define, align and deliver payment initiatives and new/enhanced policy development.
• Influence leadership to adopt new ideas, approaches and/or products.

Skills

Policy development

Data analysis

Stakeholder engagement

Presentation

Education

High School Diploma or equivalent

BS/BA/Advanced degree in healthcare

CPC Certification

Tools

Excel

PowerPoint

Outlook

Job description

Sentara Health is seeking a Payment Policy Research Analyst to identify and present cost-saving opportunities in policy-related medical costs for Sentara Health Plan. The role involves data-driven analysis, collaboration with subject matter experts, and delivering measurable savings through policy and process improvements.

Responsibilities include researching internal payment policies, developing strategies, and presenting findings to stakeholders.