Specialist, Health Policy and Payment

APTA•Alexandria, VA

2d•$75,000 - $80,000•Onsite

About The Position

This position will support the association's advocacy and initiatives related to commercial and Medicare payment, coding and billing, federal regulation and policy, and health plan policies and procedures affecting physical therapist practice. The position serves as a key contributor to APTA’s payment strategy, supporting efforts involving commercial insurers, traditional Medicare and Medicare Advantage, CPT coding Relative Value Scale Update Committee (RUC) processes, payment valuation, value-based care, administrative burden reduction, quality initiatives, and health information technology. Assists with monitoring payer and regulatory developments, analyzing payment and coverage policies; developing member resources and educational materials; advocacy efforts with health plans, federal agencies, and other industry players. Works collaboratively to improve payment and reduce burden impacting the physical therapy profession.

Requirements

Bachelor's degree preferred, advanced degree a plus
5+ years’ experience with and understanding of health care policy and advocacy
Knowledge of commercial insurance reimbursement, health plan policy development and payer priorities and operations with working knowledge of coding and billing principles, CPT coding and processes, and reimbursement methodologies
Experience in monitoring and analyzing payer policies, federal regulations and guidance documents including regarding the Medicare physician fee schedule, Medicare Advantage and in formulating and advancing public policy, a plus if specific to physical therapy
Demonstrated project management capabilities
Excellent and effective written and verbal communication skills and the ability to communicate complicated issues clearly and effectively to a broad range of stakeholders and audience sizes
Must be a highly organized and detail-oriented self-starter with strong analytical and problem-solving skills, experienced in handling a variety of multiple projects with proven abilities in prioritizing deadlines and seeing projects to completion
Ability to manage multiple priorities, work independently and collaboratively on a team and with external players to be responsive to members including responses to subject matter inquiries
Must be proficient in MS Office, advanced Excel a plus; web-based applications

Nice To Haves

Knowledge of value-based care, alternative payment models, and payment reform initiatives a plus

Responsibilities

Support APTA advocacy with commercial payers, federal agencies, members, coalitions, and other industry players
Monitor, analyze and develop communication on commercial payer policies, Medicare payment policies, and other reimbursement developments affecting physical therapy practice for members and other constituents
Create content and resources for company website and other communications and presentations to educate and inform members and other audiences on efforts to support the association’s health payment priorities
Collaborate with Government Affairs, Communications, and other APTA departments and external teams on issues impacting the physical therapy profession
Support outreach and communication with insurance companies, federal agencies, member leaders, coalitions, and other external
Participate in some evening virtual meetings
Upholds and fosters APTA Staff Values
Complies with all APTA policies and procedures
Performs other duties as assigned to foster achievement of association priorities