Senior Payer Policy Analyst

🔥 1 minute ago

🌲 North Carolina – Remote

🌲 North Carolina – Remote

💵 $85k - $110k / year

⏰ Full Time

🟠 Senior

🧐 Analyst

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Labcorp

WebsiteLinkedInAll Job Openings

10,000+ employees

Founded 1969

💼 Consulting

📦 Logistics

🏥 Healthcare

💰 Post-IPO Debt on 2019-06

Consulting • Logistics • Healthcare

Labcorp is a leading global life sciences company that provides comprehensive clinical laboratory and end-to-end drug development services. The company offers a wide range of diagnostic tests and services for patients, providers, and biopharmaceutical companies. Labcorp specializes in areas such as oncology, women's health, neurology, and genetics, offering both routine and specialized laboratory testing. It supports healthcare systems and organizations with clinical lab testing, health assessments, and employee wellness programs. Labcorp also plays a significant role in the biopharma sector, providing nonclinical research, central laboratory services, and consulting for drug development and commercialization. With their commitment to science and innovation, Labcorp aims to improve health and change lives worldwide.

📋 Description

• Assist the Manager of Payer Policy and Relations with policy and alliance development activities • Assist with developing and implementing policy strategies supporting Labcorp and the laboratory industry at state and federal levels • Gather and share information related to policy, billing, and reimbursement issues as an internal conduit • Develop relationships with state Medicaid contacts to improve reimbursement for genetic testing • Work with Segment Science and Marketing management teams to understand existing and emerging technologies and provide education, appeals influence, and payer-policy insight • Attend payer meetings with Payor Solutions Account Executives to communicate policy concerns and denial trends • Monitor payer policy updates and changes, including NCD, LCD, and other coverage policies impacting revenue • Liaise between Labcorp Medical Directors and Government and Commercial Payer Medical Directors on existing and proposed payer policies • Assist with regulatory comments, written testimony, policy position papers, and regulations; analyze public policy, legislative, and regulatory proposals • Help develop policy positions, strategies, and tactics and advocate company positions regarding legislation, regulations, and public policy • Support efforts addressing Medicare and private-sector payer price erosion associated with PAMA • Develop responses, talking points, and strategies on key state and federal issues • Advocate company positions before, during, and after meetings with trade associations, professional associations, laboratory coalitions, Medicaid Review boards, and other groups • Communicate developments and updates through periodic reports and internal and external communications channels • Examine healthcare trends and monitor implementation of Government Health Care Acts to identify business implications, opportunities, and risks • Evaluate laboratory-related state legislation and laws and engage subject matter experts to determine impacts and next steps • Craft language based on state laws to appeal claim denials and pursue payer reimbursement • Develop and maintain contacts with policymakers for Medicare Contractors, Medicaid Payers, and Commercial insurers • Collaborate with third-party groups affected by Medicare, Medicaid, and CLIA regulations impacting laboratory services • Perform other duties assigned by the Manager, Director, and/or Vice President of Payer Policy

🎯 Requirements

• Bachelor’s degree with 5+ years work experience required; if no degree, minimum 7 years work experience required • Advanced degree; MBA, JD, M.A. / M.S., CGC, RN preferred • Microsoft Suite experience with at minimum Intermediate Excel Skills (pivot tables, VLOOKUP’s) preferred • 3+ years’ experience developing State Medicaid relationships and reimbursements for genetic testing preferred • 5+ years’ experience in a clinical or business setting preferred • 3+ years’ experience with insurance guidelines and payer policy preferred • 3+ years’ experience with state and federal agencies and commercial insurance payers preferred • 3+ years’ experience in healthcare revenue cycle, including prior authorization, coding, claims, denials, appeals, and billing compliance preferred • Strong written, verbal, and presentation skills • Ability to express complex information clearly and concisely to personnel at all levels • Capacity to work independently and manage multiple projects • Experience taking ownership of issues and providing practical advice • Ability to prioritize and undertake mission critical tasks in a fast-paced environment

🏖️ Benefits

• Medical insurance • Dental insurance • Vision insurance • Life insurance • Short-term disability (STD) • Long-term disability (LTD) • 401(k) Plan • Paid Time Off (PTO) or Flexible Time Off (FTO) • Tuition Reimbursement • Employee Stock Purchase Plan

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