Assistant Director Economic and Regulatory Affairs CPT

College of American Pathologists•Washington, DC

12d•Onsite

About The Position

This role leads and advances the College of American Pathologists’ (CAP) Current Procedural Terminology (CPT) coding, valuation, and payment policy advocacy by developing strategic CPT proposals, coordinating engagement with the American Medical Association (AMA) and federal regulators, and ensuring effective representation of pathology and laboratory interests across regulatory and stakeholder forums. The Assistant Director, Economic and Regulatory Affairs (CPT) is responsible for overseeing multiple payment policy initiatives impacted by the CAP’s CPT advocacy requiring close coordination with internal and external staff and physician leaders from the AMA CPT, laboratory and industry associations, physician medical specialty societies as well as CAP resource committees. This includes all facets of the development of CPT coding strategies and proposals, collaborating closely with members and staff regarding new and existing technologies for AMA CPT code change proposals. The role also coordinates CAP participation in the CPT Advisory Committee and serves as the primary contact with AMA CPT Editorial Panel activity for pathology and laboratory issues, coordinating and leading the CAP/AMA Pathology Coding Caucus (PCC). Additionally, the position staffs the CPT/AMA/Specialty Society Relative Value Scale Update Committee (RUC) Subcommittee of the Economic Affairs Committee, develops and recommends policies and strategies for coding and valuation advocacy, and advocates with assigned federal agencies and representatives for the adoption of federal policy consistent with CAP policy and strategies. The role interfaces with all internal and external areas impacted by pathology and laboratory CPT advocacy activities, manages all aspects of and development of the valuation processes of clinical laboratory fee schedule services, and works with CAP advisors, industry stakeholder groups, and the Centers for Medicare and Medicaid Services (CMS) representatives. Responsible for development of close working relationships with AMA CPT and regulatory and government agencies, with close coordination with CAP committee members and staff, payment policy staff of other physician, laboratory and laboratory industry organizations, and CMS officials.

Requirements

Strong oral and written communication skills.
Highly self-motivated and effectively work independently.
Must be able to work collaboratively in a diverse work environment with CAP members and staff.
Must possess a strong understanding of coding and billing protocols, as well as an in-depth knowledge of federal, state and private sector reimbursement programs.
Strong capability to use and apply project management techniques to achieve project goals.
Ability to independently handle multiple technically complex projects simultaneously.
Ability to independently analyze and edit policies/proposals both for content and tone.
Ability to independently meet externally and internally imposed deadlines for completion of work.
Ability to work with staff and members to formulate strategy on controversial and complex issues and in adverse political environments.
Proficient in Microsoft Word, Excel and PowerPoint.
Bachelor’s degree required, preferably in an area of health science.
Experience in health payment policy/CPT coding.
5 to 10 years’ experience in health policy analysis required.
Specific experience in developing, executing and managing successful strategies and building internal consensus.

Nice To Haves

Master’s Degree in health services administration, public health, public health, health policy, government affairs or similar relevant area a plus.
Certified Professional Coder helpful but not required.
Prior federal agency and medical society or association experience preferred.
Knowledge of pathology or laboratory medicine issues a plus but not required.

Responsibilities

Develop CPT proposals in coordination with the CAP advisors involved in CPT activities.
Coordinate AMA CPT Advisory Committee activities for all laboratory and pathology issues. Initiate CPT code development.
Represent the CAP and pathologists’ interests at government, specialty society, or other meetings/briefings.
Develop strategies to influence regulatory agencies, specialty societies and/or other stakeholders.
Develop and maintain working relationships with CPT staff of the AMA and all pathology and laboratory organizations as well as with CMS agency officials.
Plan coordinate and execute all aspects of the AMA PCC, which consists of physician and non-physician stakeholders from major pathology and laboratory organizations to develop industry-wide consensus recommendations to the CPT Editorial Panel.
Represent the CAP and the PCC at all AMA CPT Editorial Panel meetings, government or other meeting/briefings.
Monitors and develops CAP strategy and comments regarding National Correct Coding Initiative (NCCI) issues and advocacy. Effectively coordinate advocacy with the AMA and other stakeholders.
Create and assist in the development of CAP newsletter, website and other media content as needed.
Work in conjunction with Director and Assistant Director (RUC) to plan activities of the CPT/RUC Subcommittee of the Economic Affairs Committee.
Works closely with the Assistant Director of Economic and Regulatory Affairs responsible for AMA RUC activities and the Manager of Economic and Regulatory Affairs on valuation, coding, and health policy issues.
Review CAP newsletter articles and other documents addressing coding and reimbursement issues for their accuracy and relevance to the membership.