Sr Payer Policy Analyst

labcorp; United States; A distancia; USD 90.000 - 135.000; Jornada completa

Descripción de la vacante

Labcorp is seeking a REMOTE Senior Payer Policy Analyst to join our team. The role focuses on policy development, payer relations, and reimbursement strategies at state and federal levels.

The analyst will gather and share information on policy, billing and reimbursement issues, with a strong emphasis on Medicaid and genetic testing reimbursement. Regular interaction with government and payer stakeholders is expected.

Formación

• Bachelor’s degree with 5+ years work experience required.
• Advanced degree preferred (MBA, JD, M.A./M.S., CGC, RN).
• Experience with state Medicaid relationships and reimbursements for genetic testing is a plus.
• Experience in a clinical or business setting is beneficial.
• Strong understanding of insurer guidelines and payer policy.

Responsabilidades

• Develops policy positions and comments on regulatory proposals.
• Represents LabCorp in policy discussions with government and payers.
• Monitors Medicaid and payer policy updates affecting reimbursement.
• Educates segments on payer policies and denial trends.
• Drafts testimony, position papers and regulatory analyses.

Conocimientos

Policy analysis

Stakeholder engagement

Regulatory knowledge

Communication

Educación

Bachelor's degree

Advanced degree (MBA/JD/M.A./M.S.)

Herramientas

Microsoft Excel

Descripción del empleo

Labcorp is a global leader in laboratory services, providing the insights and answers that help healthcare providers, patients, researchers, pharmaceutical companies and health systems make confident decisions and improve outcomes. Through our unparalleled science, data, technology and laboratory network, we advance diagnostics, accelerate innovation and help address some of the world’s most important health challenges. As we shape the future of healthcare, we are leveraging advanced technologies, intelligent digital solutions and data-driven innovation across our operations to enhance how work gets done and deliver greater value to customers and patients. With our global scale and deep expertise, you’ll have the opportunity to do meaningful work, grow your career and make a real impact on people’s health around the world. Together, we’re improving health and improving lives.

Labcorp is seeking a REMOTE Senior Payer Policy Analyst to join our team!

The Senior Payer Policy Analyst is responsible for assisting the Manager of Payer Policy and Relations with policy and alliance development activities for the company, including assistance with development and implementation of policy strategies to support LabCorp and the laboratory industry at the state and federal levels. The Analyst will act as internal conduit to gather and share information as it relates to policy, billing and reimbursement issues. The Analyst will primarily focus on developing relationships with state Medicaid contacts to improve reimbursement for genetic testing.

Work Schedule: Monday – Friday; 8:00am-5:00pm EST (flexible across time zones)

Core Responsibilities:

• Works directly with Segment Science and Marketing management teams to develop an understanding of existing and emerging technologies to provide education, appeals influence and insight pertaining to payer policy for Government and Commercial payers.
• Provide support to include attending Payer meetings with Payor Solutions Account Executives to communicate specific policy concerns and denials trends.
• Regularly monitors payer policy updates and changes such as NCD, LCD and other coverage policies impacting revenue.
• Functions as a liaison between LabCorp Medical Directors and Government and Commercial Payer Medical Directors on issues pertaining to existing payer policies and proposed policy changes impacting reimbursement.
• Will assist the Manager with subject matter expertise for the development of comments on regulatory proposals, written testimony, policy position papers and regulations that affect the company, analyzing public policy, legislative and regulatory proposals, and reporting internally as required.
• Coordinates with the Payer and Policy Relations Team to help develop LabCorp’s policy positions, strategy and tactics, and advocates company positions regarding new or amended legislation, regulations, or public policy. Helps support efforts in defending against risk of Medicare and private sector payer price erosion associated with the Protecting Access to Medicare Act of 2014(PAMA).
• Supports efforts at the state and federal levels as appropriate by developing responses, talking points, strategies on key issues while helping to assure policy consistency across the organization.
• Assists in advocating company positions orally and in writing before, during and after meetings at ACLA (the clinical laboratory trade association), with other trade and professional associations, with laboratory coalitions (e.g., CCLA, PLUGS, AECS, Medicaid Review boards, ICD-10 coalition, CMS Provider Compliance Group), and others.
• Communicate developments and updates on a regular basis through periodic reporting mechanisms and appropriate internal and external communications channels.
• Examines health care trends, monitors implementation of Government Health Care Acts to inform business of implications and identify potential opportunities and/or risk for Medicare, Medicaid, Accountable Care Organizations, and Commercial payers.
• Evaluates laboratory-related state legislation and laws to engage subject matter experts to determine potential impacts and next steps
• Crafts language based on state laws to assist in appealing claim denials and pursue payer reimbursement.
• Develops and maintains key contacts and relationships with policy makers for Medicare Contractors, Medicaid Payers and Commercial insurers. Ability to collaborate with third party groups affected by Medicare, Medicaid, and CLIA regulations that impact lab services.
• Performs other and further duties and responsibilities as shall be assigned by the manager, Director and/or Vice President of Payer Policy.

Minimum Qualifications:

• Bachelor’s degree with 5+ years work experience required (If no degree- minimum 7 years work experience required).

Preferred Qualifications:

• Advanced degree; MBA, JD, M.A. / M.S., CGC, RN
• Microsoft Suite experience with at minimum Intermediate Excel Skills (pivot tables, VLOOKUP’s)
• 3+ years’ experience developing State Medicaid relationships and reimbursements for genetic testing
• 5+ years’ experience in a clinical or business setting
• 3+ years’ experience with insurance guidelines and payer policy