About this opportunity
sentara lists this Payment Policy Research Analyst opportunity in virginia beach, Virginia. Review the employer’s description below for duties, qualifications and application requirements.
Job description
City/State
Virginia Beach, VA
Work Shift
First (Days)
Overview
Payment Policy Research Analyst & Technical Writer is responsible for the identification, development & presentation of new policy-related medical cost savings opportunities on behalf of Sentara Health Plan (SHP). You will assess new opportunities based on data insights leveraging tools, policies, industry trends & by soliciting input from subject matter experts across SHP. You will work with internal & external business constituents to determine opportunities for growth w/in our core payment/reimbursement policies & be responsible for savings delivery through deployment.
Primary Responsibilities
Research & assessment of internal payment policies & payment solutions in relation to competitors & industry standards to identify new cost savings opportunities
Determine potential strategies &/or solutions 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
Education
High School Diploma or equivalent (Required)
Bachelor Level Degree (Preferred)
Certification/Licensure
Certificate of Professional Coder- CPC Certification (Required)
Experience
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
CPC required within first 6 months of hire
Qualified Candidates will possess
Experience presenting, collaborating & consulting with a variety of stakeholders or clients across multiple functional areas
Experience managing multiple concurrent projects & meet tight delivery timelines
Innovative thinker that works well in an ambiguous, growth environment
Intermediate computer skills with Excel, PowerPoint & Outlook with minimal supervision:
Excel - Create spreadsheets, manipulate data & create pivot tables/reporting
PowerPoint - Create professional looking presentations
Outlook - Schedule meetings, coordination, task tracking
Preferred
Knowledge of statistical methods used in the evaluation of healthcare claims data
Professional & Institutional reimbursement experience includes coding certifications
Reimbursement policy &/or technical writing experience for development & publication
Remote Work Schedule Opportunity
Compensation
We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $105,560.00 - $162,552.00 annually. Additional compensation may be available for this role, such as shift differentials, on-call pay, shift premiums, extra-shift incentives, or bonus opportunities. Compensation within the range may vary based on qualifications, experience, location, market conditions, and business needs. Note: If an annual salary is posted, it is based on a full-time colleague working 2,080 hours annually.
Benefits
Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; 401(k)/403(b) with employer match; paid time off (vacation, sick time, and holidays); paid parental and military leave; educational assistance or student loan repayment; and voluntary benefits.
Benefits:
Caring For Your Family and Your Career
Medical, Dental, Vision plans
Adoption, Fertility and Surrogacy Reimbursement up to $10,000
Paid Time Off and Sick Leave
Paid Parental & Family Caregiver Leave
Emergency Backup Care
Long-Term, Short-Term Disability, and Critical Illness plans
Life Insurance
401k/403B with Employer Match
Tuition Assistance - $5,250/year and discounted educational opportunities through Guild Education
Student Debt Pay Down - $10,000
Pet Insurance
Legal Resources Plan
Colleagues have the opportunity to earn an annual discretionary bonus if established system and employee eligibility criteria is met.
Equal Employment Opportunity
Sentara Health is an equal opportunity employer and prides itself on the diversity and inclusiveness of its close to an almost 30,000-member workforce. Diversity, inclusion, and belonging is a guiding principle of the organization to ensure its workforce reflects the communities it serves.
Mission
In support of our mission "to improve health every day," this is a tobacco-free environment.
Remote Locations
For positions that are available as remote work, Sentara Health employs associates in the following states: Alabama, Delaware, Florida, Georgia, Idaho, Indiana, Kansas, Louisiana, Maine, Maryland, Minnesota, Nebraska, Nevada, New Hampshire, North Carolina, North Dakota, Ohio, Oklahoma, Pennsylvania, South Carolina, South Dakota, Tennesse
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Worksite address
virginia beach, VA, 23450, US
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.