Sr Payer Policy Analyst- remote

Laboratory Corporation; Burlington (NC); Remote; USD 76,000 - 100,000; Full time

Job summary

An established industry player is seeking a Senior Payer Policy Analyst to enhance healthcare delivery through strategic policy development and relationship management. This role involves collaborating with internal teams and external stakeholders to navigate complex payer policies, ensuring optimal reimbursement for genetic testing. The ideal candidate will leverage their expertise in healthcare revenue cycles and policy advocacy to influence state and federal regulations. Join a dedicated team committed to transforming healthcare and making a meaningful impact on patient outcomes.

Benefits

Medical Insurance

Dental Insurance

Vision Insurance

401(k) Plan

Paid Time Off

Tuition Reimbursement

Employee Stock Purchase Plan

Qualifications

• 5+ years experience in payer policy analysis and development.
• Strong preference for advanced degrees and experience with Medicaid relationships.

Responsibilities

• Develop and implement policy strategies for LabCorp and the lab industry.
• Monitor payer policy updates and advocate for company positions.

Skills

Payer Policy Analysis

Relationship Management

Healthcare Revenue Cycle

Policy Development

Regulatory Compliance

Education

Bachelor's Degree

Advanced Degree (MBA, JD, M.A./M.S.)

Job description

At Labcorp, you are part of a journey to accelerate life-changing healthcare breakthroughs and improve the delivery of care for all. You’ll be inspired to discover more, develop new skills and pursue career-building opportunities as we help solve some of today’s biggest health challenges around the world. Together, let’s embrace possibilities and change lives!

Sr. Payer Policy Analyst

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 in order to improve reimbursement for genetic testing.

Duties and 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 with regard to 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, strategy 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.

• Communicates 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.

Qualifications:

Bachelor’s degree from an accredited four-year institution and 5 years work experience required (If no degree- minimum 7 years work experience required).

Strong preference given to:

• Advanced degree ; MBA, JD, M.A. / M.S., CGC, RN
• Prior experience in developing State Medicaid relationships and reimbursements for genetic testing
• Prior work experience in a clinical or business setting.
• Prior work experience with insurance guidelines and payer policy.
• Prior work experience with state and federal agencies and commercial insurance payers.
• Prior work experience in healthcare revenue cycle (prior authorization, coding, claims, denials, appeals, billing compliance, etc.).

Application Window Closes: 5-5-25

Pay Range: $76-100K (State minimum wages apply if higher)

Shift: Monday-Friday; 8:00am-5:00pm EST

All job offers will bebased on a candidate’s skills and prior relevant experience, applicabledegrees/certifications,as well as internal equity and market data.

Benefits: Employees regularly scheduled to work 20 or more hours per week are eligible for comprehensive benefits including: Medical, Dental, Vision, Life, STD/LTD, 401(k), Paid Time Off (PTO) or Flexible Time Off (FTO), Tuition Reimbursement and Employee Stock Purchase Plan. Casual, PRN & Part Time employees regularly scheduled to work less than 20 hours are eligible to participate in the 401(k) Plan only. For more detailed information, pleaseclick here.

Labcorp is proud to be an Equal Opportunity Employer:

Labcorp strives for inclusion and belonging in the workforce and does not tolerate harassment or discrimination of any kind. We make employment decisions based on the needs of our business and the qualifications and merit of the individual. Qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex (including pregnancy, childbirth, or related medical conditions), family or parental status, marital, civil union or domestic partnership status, sexual orientation, gender identity, gender expression, personal appearance, age, veteran status, disability, genetic information, or any other legally protected characteristic. Additionally, all qualified applicants with arrest or conviction records will be considered for employment in accordance with applicable law.

We encourage all to apply

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