Remote Payment Policy & Cost-Savings Analyst

Sentara Health; Sioux Falls (SD); Remote; USD 106,000 - 163,000; Full time

Benefits offered by this job

Discretionary bonus

Comprehensive benefits

Job summary

Sentara Health Plan (SHP) seeks a Payment Policy Research Analyst & Technical Writer to identify and present new cost savings opportunities. You will analyze data insights, engage with subject matter experts, and deploy savings initiatives across SHP’s payment policies.

Responsibilities include evaluating internal policies, suggesting policy enhancements, and coordinating with stakeholders to deliver revised reimbursement strategies and technical documentation.

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 cost savings opportunities for SHP.
• Assess policies and payment solutions relative to competitors and industry standards.
• Define potential strategies to achieve cost savings (policy development, criteria, contracts, claims editing).
• Establish relationships with stakeholders to deliver payment initiatives and policy development.

Skills

Data analysis

Healthcare claims knowledge

Project management

Communication skills

Education

High School Diploma or equivalent

Bachelor's degree in health care or related field

Tools

Excel

PowerPoint

Outlook

Coding certifications

Job description

Sentara Health Plan (SHP) seeks a Payment Policy Research Analyst & Technical Writer to identify and present new cost savings opportunities. You will analyze data insights, engage with subject matter experts, and deploy savings initiatives across SHP’s payment policies.

Responsibilities include evaluating internal policies, suggesting policy enhancements, and coordinating with stakeholders to deliver revised reimbursement strategies and technical documentation.