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Description

Become part of an inclusive organization with over 40,000 teammates, whose mission is to improve the health and well-being of the unique communities we serve.

Summary:

Assists in the interpretation, communication, tracking and implementation of CMS (Medicare and Medicaid), Tricare and private payer policies that directly impact provider billing. Plays a critical role in researching, analyzing and conveying federal, state, and private policies that impacts Medicare, Medicaid, and commercial coverage, compliance and billing, along with becoming an expert on key issues related to changes in health care policy, including but not limited to health care reform.

Responsibilities:

1. Accountable for driving all necessary changes as a result of payer or healthcare reform updates, in a leadership capacity. Works collaboratively across the HCS and Clinical departments to ensure that information and tasks are disseminated appropriately and timely.

2. Collaborate with Senior Leadership regarding high impact/dollar policy issues while keeping them informed of policy related changes. Collaborate with Senior Leadership on project management efforts.

3. Coordinate collaborative meetings with Medicare and Medicaid and academic teaching health care systems within North Carolina and across several states. Participate in monthly Medicare and Medicaid meetings for policy questions and interpretations.

4. Develop project plans and goals identifies resources needed, develops schedules and methods for measuring results while maintaining optimum working relationships. Responsible for program and project assignments working independently or collaboratively as appropriate to accomplish the assigned work. Identify issues and assist in developing strategies to address them prior to issues becoming critical. Keep senior management informed of project(s) status and any potential concerns.

5. Establish working relationships within Medicare and Medicaid (and other private payers as needed) to drive policy discussions that will enable UNC Health Care to maximize reimbursement in a compliant and collaborative manner.

6. Provide complex analysis and queries to determine impacts of policy/program changes.

7. Responsible and accountable for reviewing all relevant payer policy alerts (e.g. bulletins) and/or Notices of Proposed Rule Making and Final Rules.

8. Responsible for dissemination of appropriate information to key stakeholders throughout the HCS. The information may be policy or program alerts. The individual will interpret the information and send out concise and accurate communication to community.

9. Review and interpret health care reform updates and notify key stakeholders, as appropriate. Responsible for establishing appropriate project management to lead the change.

Other Information

Other information:

Education Requirements:

• Bachelor’s degree in Business Administration, Health Administration, Communications or related field.

Licensure/Certification Requirements:

• If appropriate for the position, a willingness to secure coding certification may be required.

Professional Experience Requirements:

• Three (3) years of experience in policy interpretation and accountability in a healthcare setting.

Knowledge/Skills/and Abilities Requirements:

• Strong analytical, communications, and change management skills with solid knowledge of project management. Must be able to work independently. Research, retrieve, analyze and organize data.

Job Details

Legal Employer: NCHEALTH

Entity: Shared Services

Organization Unit: Managed Care

Work Type: Full Time

Standard Hours Per Week: 40.00

Salary Range: $26.59 - $38.23 per hour (Hiring Range)

Pay offers are determined by experience and internal equity

Work Assignment Type: Remote

Work Schedule: Day Job

Location of Job: US:NC:Chapel Hill

Exempt From Overtime: Exempt: Yes

This position is employed by NC Health (Rex Healthcare, Inc., d/b/a NC Health), a private, fully-owned subsidiary of UNC Health Care System, in a department that provides shared services to operations across UNC Health Care; except that, if you are currently a UNCHCS State employee already working in a designated shared services department, you may remain a UNCHCS State employee if selected for this job.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

UNC Health makes reasonable accommodations for applicants' and employees' religious practices and beliefs, as well as applicants and employees with disabilities. All interested applicants are invited to apply for career opportunities. Please email [email protected] if you need a reasonable accommodation to search and/or to apply for a career opportunity.

Qualified applicants will be considered without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.