Manage the Payment and Coding Policy team within the Healthcare Value Advancement department at AZ Blue. Oversee payment strategies, coding policies, and analytical insights for provider reimbursement.
Responsibilities
Manage the day-to-day activities of the Payment and Coding Policy area within the Healthcare Value Advancement (HVA) department.
Serve as the primary contact and resource for staff.
Provide oversight, direction, development, problem resolution and leadership for the Team.
Drive corporate payment strategy and coding policy that ensures appropriate, accurate and predictable provider reimbursement for Commercial, Medicare and FEP products.
Ensure that payment and coding policies are properly maintained and integrated into claims processing systems and vendor solutions.
Lead overall strategic direction and execution of coding updates, coding guidelines, industry standard coding practices, billing issues, and payment, taking into consideration possible business implications.
Oversee development of strategic analyses that impact business decisions, improve efficiency and drive innovation.
Transform data and analytics into meaningful and actionable information.
Ensure strategic alignment between HealthCare Value Advancement (HVA) projects and the organization's broader goals.
Integrate analytics strategy into the execution process, including program management, project controls, communications, and vendor oversight.
Requirements
5 years of experience in analytics and 5 years of experience working for a healthcare organization / health insurer (Level 1)
3 years of experience in supervisory/management role (Level 1)
10 years of experience in analytics and 10 years of experience working for a healthcare organization / health insurer (Level 2)
7 years of managerial experience (Level 2)
Bachelor’s degree in a quantitative, healthcare administrative, business, or related field of study
Preferred Work Experience 15 years of experience in a healthcare analytics role for a health insurer on a team such as informatics, healthcare economics, or actuarial (All Levels)
5 years of managerial experience (Level 1)
10 years of managerial experience (Level 2)
Experience developing provider reimbursement and financial impact analyses (All Levels)
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