The Payment Policy Analyst II is an internal subject matter expert with an advanced level of proficiency In Medicare/Medicaid reimbursement methodologies, laws, and regulations. This hire will work closely with our subject matter experts and team members and will also provide training to junior research analysts. This self-motivated individual must be able to grasp complex software and data quickly and thoroughly. The successful candidate will also be organized and possess good communication skills and advanced developed writing skills. Attention to detail is a must. He/she must be comfortable in an agile development environment and meet assigned deliverables prior to the end of sprint cycles. This person will also be a true team player who is flexible to lend a hand on other projects as needed.
What you will do:
- Provide an advanced level of proficiency in Medicare/Medicaid reimbursement (payment laws, regulations, policies, methodologies, and rates/algorithms).
- Interpret and deliver advanced, accurate and timely business requirements covering reimbursement updates and payment policy changes and enhancement features for translation into software design specifications.
- Coordinate with developers, QA, data, client service and other team members to ensure that business requirements are implemented accurately and timely.
- Develop test claims for Developers, UAT and QA.
- Develop and maintain an advanced level of proficiency in the Company’s products (software, data) and services, including commercial contracting features as related to the specific area(s) assigned
- Work towards becoming SME in assigned Provider Payment Systems like APC, DRG, RBRVS etc.
- Develop and deliver internal and external educational presentations related to Medicare/Medicaid reimbursement or commercial contracting features.
What you bring:
- Bachelor’s degree in a healthcare or comparable field.
- 4-7 years professional experience in healthcare, and familiarity with health care reimbursement systems and methodologies
- Prior Experience in a specific Medicare or Medicaid or commercial reimbursement arena.
- A positive, optimistic, “can-do” attitude.
- Proven effectiveness in collaborating with cross-functional teams to completion of projects.
- Demonstrated ability to effectively communicate and collaborate with diverse internal and external stakeholder groups and individuals.
- Ability to collect, research, and understand complex or diverse information, and translate it into clear, concise, and accurate written requirements.
- Ability to plan, prioritize, and balance the need for direction with self-motivated efforts.
- Demonstrate strong interpersonal skills; treats people with respect, keeps commitments, inspires the trust of others, works ethically and with integrity, and upholds organizational values.
- Experience using MS Office (Word, Excel, PowerPoint, Visio, Access) software applications
- Experience using various Web-based and other research sources and tools
- Experience in an agile systems development life cycle (SDLC) environment.
Who you are:
- Creative entrepreneur. You have a constant drive to make things better; you question the status quo and approach common challenges with creativity and constructive criticism. You have skills to share ideas clearly and convincingly in a way that adapts to your audience, regardless of function, level, or expertise.
- Critical, big-picture thinker. You have a constant thirst for knowledge and the ability to credibly share it with others, whether internally or externally. You are analytical, evaluating logic-based details while always considering and problem-solving for the sake of the big picture.
- Self-starter. You are proactive, self-motivated, and able to push work, start initiatives, and provide ideas independently in a team environment.
- Team player & coach. You can foster professional and personal respect from others and find success in a team setting. While highly collaborative, you have natural management skills and know how to grow and develop people.
- Adaptable multi-tasker. You are highly organized and flexible. You know how to manage expectations and can thrive in fast-paced, constantly changing environments and successfully adapt to a variety of tasks.
How we work:
- We work together and help each other do our best by building on our work across teams and offices. We do not own individual ideas or seek credit.
- User-driven. We place our clients and our users’ needs above all else. If it matters to a user, it matters to us. We work for them and keep ourselves accountable to that.
- Hands-on. We do not wait for problems to solve themselves. We enter the thick of it and get things done.
- Impact over ego. Our culture is about results, not ownership. Great ideas have seniority over titles and levels, and great thinkers outshine fancy pedigrees.
- Forward-looking. We look beyond our own world to constantly improve our business. We welcome outside speakers, tap into the latest tech, and make sure we are future proof in anticipation of what is coming next.
- Caring & close knit. We know and care about our people. We know each other’s project strengths—but also about upcoming family trips and favorite after-work drinks.