Policy Research Analyst

Position: Payment Policy Research Analyst
## Payment Policy Research Analyst Apply:
Remote:
Virginia Beach, VA:
Full time:
Posted Today:
JR-107843
** City/State
** Virginia Beach, VA
** Work Shift
** First (Days)
** Overview:**#
** Payment Policy Research Analyst
** 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
* Remote Work Schedule Opportunity  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  Power Point
- 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

We provide market-competitive compensation packages, inclusive of base pay, incentives, and benefits. The base pay range for full-time employment is $ - $ 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.

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.  
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