Manager, Reimbursement Policy
Job Details
American Psychiatric Association HQ - Washington, DC
Full Time

POSITION SUMMARY

 

The Manager, Reimbursement Policy and Quality, provides broad-based managerial support and expertise on a range of physician payment, coding/billing, coverage issues, and quality improvement initiatives. Ideal candidates are comfortable working in a fast-paced environment, managing multiple project deadlines and can work collaboratively in a team environment. Occasional evening conference calls and weekend travel is required.

 

ESSENTIAL DUTIES AND RESPONSIBILITIES

  • Manage activities to related to implementation of relevant laws/regulations/coverage policies related to physician reimbursement and coverage of psychiatric services and development of educational materials and content for the membership
    • Monitor Federal Register Notice for relevant announcements regarding regulations, meetings, and executive orders.
    • Identify Medicare/Medicaid-related regulations, policies and other documents. Track and analyze coding payment and coverage issues of interest to the specialty. Assist in the development of public comment letters and draft expert responses to proposed policy changes.
    • Monitor private sector payment initiatives including coverage policy criteria and value-based payment initiatives.
    • Develop and assist with the promotion of toolkits, webinars and other practice management resources to help improve the efficiency, effectiveness, and profitability of member practices.
    • Ensure that payment and quality content on APA website is accurate and timely.
    • Assist with APAs CPT and AMA/Specialty Society RVS Update Committee (RUC) work and projects.
    • Support outreach to relevant agency staff to incorporate APA priorities in regulations, guidance, and programs
    • Help respond to inquiries from APA members, district branches, mental health care organizations, regarding payment including CPT coding/billing and documentation, quality improvement, etc.
  • Provide administrative support to manage workflow for Reimbursement Policy and Quality components (Committee on RBRVS, Codes and Reimbursement, Committee on Reimbursement for Psychiatric Care, Council on Quality Care and relevant committees)
    • Work with the Councils/Committee to move forward work products and seek feedback/expertise as necessary on policies and activities under their purview
    • Work across the division to support and provide feedback to relevant workgroups under other councils and participate in calls and meetings
    • Coordinate scheduling of conference calls and meetings, take minutes and provide support in drafting standard reports
  • Manage efforts to track policy trends related to reimbursement and quality policy
    • Ongoing review of pertinent literature and studies
    • Support development of policy briefs on specific issues as directed
  • Other duties as assigned

 

 

REQUIRED SKILLS, EXPERIENCE, AND QUALIFICATIONS

  • Bachelors degree from an accredited college
  • Minimum 2-3 years of related work experience, such as experience in a specialty society or medical practice (behavioral health preferred) environment.
  • Coding certification (e.g. AHIMA or AAPC) and/or practice management certification (e.g., MGMA) preferred.
  • Prior experience working with membership committees
  • Knowledge of psychiatric/behavioral health coding/billing highly desired.
  • Strong analytic, research and writing skills.
  • Experience and general comfort in developing and reviewing spreadsheets.
  • Working knowledge of the federal regulatory process.
  • Ability to effectively communicate with contacts inside and outside of the organization.
  • Ability to effectively communicate with and be responsive to the needs of all members of the organization.
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