Payment Policy Research Manager

Location
Virginia Beach, VA
Salary
Competitive
Posted
Oct 05, 2020
Closes
Oct 27, 2020
Ref
139503BR
Function
Management
Industry
Healthcare
Hours
Full Time
The Payment Policy Research Manager is responsible for the identification, development, and presentation of new policy-related medical cost savings opportunities. This position will assess new opportunities based on data reporting tools, policies, and industry trends. Researches and assesses payer policies and payment integrity solutions in relation to competitors and industry standards to identify new medical cost savings opportunities. Determines potential strategies and/or solutions to achieve identified cost savings such as policy development or enhancement, contract strategy and claims editing. Participates in analytical, experimental, investigative and other fact-finding work in support of opportunity development. Influence. Recommends changes to current policy development procedures based on market research and new trends. Serves as an industry thought leader and policy SME.

Qualifications

Education Level
Bachelor's Level Degree - BUSINESS ADMINISTRATION OR
Bachelor's Level Degree - FINANCE OR
Bachelor's Level Degree - HEALTHCARE OR
Bachelor's Level Degree - STATISTICS OR
Master's Level Degree - Experience in lieu of education: Yes

Experience
Required: Health Insurance Industry - 5 years, Project Management - Previous experience, Reimbursement - Previous experience, Statistics - Previous experience

Preferred: None, unless noted in the "Other" section below

License
Required: None, unless noted in the "Other" section below

Preferred: Cert Professional Coder

Skills
Required:

Preferred: None, unless noted in the "Other" section below

Other
3+ years of experience with Healthcare payment policy and/or clinical policy5+ years' experience billing, coding, and/or auditing healthcare claimsA Masters Degree in Healthcare Management, Business, Finance, Statistics or related field is preferred

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