Analyst, Payer Advocacy & Value Solutions

The Payer and Care Delivery Policy team in the Advocacy Division of the ACC aims to position ACC members for success in a value-based payment environment. The PCDP team has four primary functions:

• Provide value-based payment surveillance and policy expertise to facilitate member participation in alternative payment models to anticipate and communicate opportunities and potential threats associated with payment reform initiatives

• Performance measure advocacy including tracking/influencing activities of quality organizations such as Battelle’s Partnership for Quality Measurement to keep ACC-stewarded measures in the Quality Payment Program (CMS) and as the preferred measures for private payers, as appropriate, through initiatives such as Core Quality Measure Collaborative

• Manage private payer relationships and lead ACC strategic direction in this area

• Manage the activities of the Population Health Management Work Group and Partners in Quality Subcommittee to advance ACC strategic plan goals

• Develop and maximize health plan relationships to facilitate collaborative problem-solving and conflict resolution.

• Lead the coordination of the College’s response to specific member or payer requests including but not limited to coverage, reimbursement, prior authorization, and access.

• Solicit and review private-payer cardiovascular medical policies; track and assess acceptance of ACC feedback into health plan medical policy. Organize strategy to address controversial policies.

• Develop policy engagement and advocacy opportunities for Medicare Advantage and CV-related pharmacy benefit plans.

• Collaborate with CV subspecialty societies and state chapter leadership on reimbursement and policy issues to unify the voice of the cardiovascular community when feasible.

• Develop relevant content and materials to inform and influence leadership, members, or external audiences regarding current or emerging topics germane to the strategic or business objectives of the department or division.

• Assist member committees including Health Affairs Committee, Population Health Management WG and Partners in Quality Subcommittee.

• Facilitate communication and collaboration within and across the College to align efforts.

• Participate as member of cross-functional team to support department activities.

• Other responsibilities as assigned

• Bachelor’s degree or equivalent experience in relevant field (public policy, health policy, etc.).

• At least 5 years progressive project management experience in physician reimbursement or provider relations. Advanced degree may be substituted for work experience.

• Substantial knowledge of managed care operations and policy and payment reform in public and private payer systems.

• Ability to work on multiple complex assignments independently and as part of a team.

• Ability to provide expertise and guidance for work teams as appropriate.

• Excellent organizational skills and attention to detail.

• Excellent time management skills and ability to work well under strict deadlines.

• Excellent oral and written communication skills.

• Desire and ability to learn new skills.

• Ability to travel (5-10%)

Desired:

Experience working for, or with, a medical association.

Experience with private payer, Medicare and regulatory issues affecting cardiovascular practice.

Familiarity with physician payment, value base care initiatives, and physician and patient quality measurement.