Senior Manager, Payment and Coding Policy
Blue Cross Blue Shield of Arizona
full-time
Posted on:
Location Type: Hybrid
Location: Phoenix • Arizona • United States
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Job Level
About the role
- 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)
- Experience supporting code editing solutions (All Levels)
- Experience working with medical coders and coding (All Levels)
Benefits
- Health insurance
- Retirement plans
- Paid time off
- Flexible work arrangements
- Professional development
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
analyticscoding policyprovider reimbursementfinancial impact analysescode editing solutionscoding guidelinesbilling issuesdata transformationstrategic analysesprogram management
Soft Skills
leadershipproblem resolutioncommunicationoversightdirectiondevelopmentstrategic alignmentinnovationteam managementorganizational skills