Posted 3 weeks ago

Senior Health Policy Analyst

Company: American Academy of Pediatrics
Category: Business, Healthcare


Type: Full Time

American Academy of Pediatrics is seeking a Senior Health Policy Analyst to join their team. You will manage the Committee on Child Health Financing (COCHF) and its subcommittee, the Payer Advocacy Advisory Committee (PAAC), and the Pediatric Council. Work with COCHF in identifying, developing and revising new policy statements related to both public and private payor child health financing including the coverage and payment policies of commercial payers and government payors such as Medicaid and Medicaid MCOs. Partner closely with federal advocacy and state advocacy to address issues related to child health financing across Medicaid, state Medicaid programs and Medicaid Managed Care. Work with general pediatricians and pediatric medical and surgical subspecialists, to identify challenges, opportunities and solutions associated with implementation of AAP clinical policy recommendations. Develop and promote materials, financial models, and strategies to help members successfully negotiate with payers including alternative payment models. Some responsibilities are the following:

  • Establish relationships with payers, national or regional business groups, and health plan associations to identify and leverage opportunities to promote the adoption of AAP policies, reports, recommendations, and clinical guidelines through appropriate payment policies.
  • Develop communication plans to address emerging/urgent policy changes that impact pediatric healthcare financing including issues impacting Medicaid payments and coverage. Utilize expert communication skills and knowledge of payer decision making processes to establish mechanisms to develop and sustain proactive payer engagement to address the needs of children and pediatric providers.
  • Provide primary staffing   for COCHF, PAAC, and the Pediatric Council including agenda development, meeting planning, preparation and dissemination of minutes, budgets and administrative follow up and  assisting Chairs in developing and implementing objectives and goals.  Utilize virtual technology to support section activities as appropriate.
  • Manage editing, proofing, reference verification of policy manuscripts, manuals, educational products, promotional materials, and other documents of COCHF. Review content of in-progress publications for consistency with existing AAP policy. Secure/negotiate copyright releases and/or reprint permissions for tables and other materials as needed.
  • Contribute expert payer policy understanding to AAP payer advocacy efforts through collaboration with AAP federal advocacy staff on legislative and/or regulatory matters pertinent to AAP policy, including reviewing Federal Register notices related to proposed rulemaking and/or exploring the significance of AAP representation at federally sponsored hearings and meetings.
  • Maintain a deep understanding of the mechanics of healthcare finance, payer and provider operations and child and family and provider needs to analyze existing policies, identify gaps and opportunities, and make recommendations to modify or develop policies that benefit children, families and providers.
  • Assist in the development of mechanisms to promote alternative payment models, including for Medicaid, and to promote financially feasible and appropriate practice payment models, including value-based payment models that are patient-centered and incorporate the key needs of members and other critical stakeholders.