Remote Payment Policy Research & Strategy Analyst

Sentara Health; Georgia; Remote; USD 106,000 - 163,000; Full time

Benefits offered by this job

Medical, Dental, Vision plans

Paid Time Off

Educational assistance

Student Debt Pay Down

401k/403B with Employer Match

Parental Leave

Life Insurance

Job summary

Sentara Health in Virginia Beach is seeking a Payment Policy Research Analyst & Technical Writer to identify and present cost-saving policy opportunities for Sentara Health Plan, based on data insights and input from subject matter experts.

You will assess opportunities, develop policy enhancements, and collaborate with stakeholders to define, align and deliver payment initiatives, with CPC certification required within six months and a remote-work option where available.

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

Skills

Policy analysis

Data interpretation

Stakeholder management

Presentation

Communication

Education

High School Diploma

Bachelor degree preferred

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

Tools

Excel

PowerPoint

Outlook

Job description

Sentara Health in Virginia Beach is seeking a Payment Policy Research Analyst & Technical Writer to identify and present cost-saving policy opportunities for Sentara Health Plan, based on data insights and input from subject matter experts.

You will assess opportunities, develop policy enhancements, and collaborate with stakeholders to define, align and deliver payment initiatives, with CPC certification required within six months and a remote-work option where available.