Remote Payment Policy & Data Insights Analyst

Sentara Health; Manchester (NH); Remote; USD 106,000 - 163,000; Full time

Benefits offered by this job

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Disability Insurance

Paid Time Off

Adoption Reimbursement

Fertility Reimbursement

Surrogacy Reimbursement

Annual Bonus Eligibility

Job summary

Sentara Health Plan is seeking a Payment Policy Research Analyst & Technical Writer to identify, develop and present new policy-related medical cost savings opportunities. You will assess opportunities using data insights, tools, policies, and input from subject matter experts across SHP, delivering savings through deployment.

You will research internal payment policies, evaluate options with stakeholders, and craft clear policy development and publication materials to support health plan goals.

Qualifications

• High School Diploma or equivalent (Required).
• Bachelor's 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

• Research & assessment of internal payment policies & payment solutions to identify cost savings opportunities.
• Determine potential strategies/solutions to achieve identified cost savings such as policy development or enhancement, authorization criteria & process, contract strategy, claims editing & more.
• Establish strong relationships with internal & external stakeholders to define, align & deliver payment initiatives & new/enhanced policy development in support of health plan goals.

Skills

Excel

PowerPoint

Outlook

Pivot tables

Data analysis

Education

High School Diploma or equivalent

Bachelor Degree (Preferred)

BS/BA/Advanced degree in health care or medical field (Preferred)

Job description

Sentara Health Plan is seeking a Payment Policy Research Analyst & Technical Writer to identify, develop and present new policy-related medical cost savings opportunities. You will assess opportunities using data insights, tools, policies, and input from subject matter experts across SHP, delivering savings through deployment.

You will research internal payment policies, evaluate options with stakeholders, and craft clear policy development and publication materials to support health plan goals.