Remote Payment Policy & Cost-Savings Analyst

Sentara Health; Idaho Falls (ID); Remote; USD 106,000 - 163,000; Full time

Benefits offered by this job

Medical insurance

Dental insurance

Vision plan

PTO

Adoption reimbursement

Fertility reimbursement

Surrogacy reimbursement

Discretionary bonus

Life Insurance

Disability insurance

Legal resources

Job summary

Sentara Health is seeking a Payment Policy Research Analyst & Technical Writer to identify, develop and present policy-related medical cost savings opportunities for the Sentara Health Plan. You will rely on data insights, external and internal SME input, and industry trends to drive savings through deployment.

The role requires a high school diploma and preferably a bachelor's, with 3 years in health plan experience or medical coding; familiarity with reimbursement policies and technical

Qualifications

• High School Diploma or equivalent is required.
• Bachelor level degree preferred.
• 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.

Responsibilities

• Identify, develop and present policy-related medical cost savings opportunities for Sentara Health Plan (SHP).
• Assess opportunities based on data insights, leveraging tools, policies, industry trends and input from subject matter experts across SHP.
• Work with internal and external stakeholders to determine opportunities for growth within core payment/reimbursement policies and be responsible for savings delivery through deployment.
• Research and assessment of internal payment policies and payment solutions relative to competitors and 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 and process, contract strategy, claims editing, and more.
• Establish strong relationships with internal and external stakeholders to define, align and deliver payment initiatives and new/enhanced policy development in support of health plan goals.

Education

High School Diploma or equivalent

Bachelor Level Degree

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

Job description

Sentara Health is seeking a Payment Policy Research Analyst & Technical Writer to identify, develop and present policy-related medical cost savings opportunities for the Sentara Health Plan. You will rely on data insights, external and internal SME input, and industry trends to drive savings through deployment.

The role requires a high school diploma and preferably a bachelor's, with 3 years in health plan experience or medical coding; familiarity with reimbursement policies and technical