Remote Payment Policy & Cost-Savings Analyst

Sentara Health; Wisconsin; On-site; USD 106,000 - 163,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Paid Time Off

401k/403(b) with employer match

Tuition Assistance

Job summary

Sentara Health is seeking a Payment Policy Research Analyst to identify and present new policy-related medical cost savings opportunities for the Sentara Health Plan. The role relies on data insights, policy expertise, and collaboration with stakeholders to deliver savings through policy deployment.

Responsibilities include researching policies, developing strategies, supporting opportunity development, and communicating with leadership.

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.

Responsibilities

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

Skills

Research & assessment

Stakeholder collaboration

Analytical thinking

Presentation skills

Project management

Data analysis

Education

High School Diploma or equivalent

Bachelor level degree

Tools

Excel

PowerPoint

Outlook

Job description

Sentara Health is seeking a Payment Policy Research Analyst to identify and present new policy-related medical cost savings opportunities for the Sentara Health Plan. The role relies on data insights, policy expertise, and collaboration with stakeholders to deliver savings through policy deployment.

Responsibilities include researching policies, developing strategies, supporting opportunity development, and communicating with leadership.