Work Shift 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. 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 Establish strong relationships with internal & external stakeholders to define, align & deliver payment initiatives & new/enhanced policy development in support of health plan goals High School Diploma or equivalent (Required) Bachelor Level Degree (Preferred) 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 Remote Work Schedule Opportunity Experience managing multiple concurrent projects & meet tight delivery timelines Intermediate computer skills with Excel, PowerPoint & Outlook with minimal supervision: Excel - Create spreadsheets, manipulate data & create pivot tables/reporting 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 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. Sentara offers a comprehensive benefits package, including medical, dental, vision, life and disability insurance; paid time off (vacation, sick time, and holidays); Medical, Dental, Vision plans
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