Health Policy & Advocacy Specialist

The American Academy of Ophthalmology is looking for a Health Policy and Advocacy Specialist. The mission of the American Academy of Ophthalmology (AAO) is to protect sight and empower lives by serving as an advocacy for patients and the public, leading ophthalmic education, supporting research, and advancing the profession of ophthalmology.

The Health Policy and Advocacy Specialist works with the Health Policy Director to develop regulatory and payment policy analysis for Academy members. They also support the critical work of the ophthalmology representatives ('Advisors') to the Current Procedural Terminology Editorial Panel (CPT) and AMA/Specialty Society RVS Update Committee (RUC) and the RUC survey process. This individual contributes to advocacy and practice education by coordinating interactions with Medicare and commercial payers on policy issues. Responsibilities for this position include:

• Coordinates the logistics of RUC surveys and special projects related to coverage and payment policy, physician reimbursement and other health policy issues. Assists the Director with the AMA RUC surveys and CPT processes.
• Attends RUC and CPT meetings as needed and maintains record of RUC and CPT meeting outcomes and tracks upcoming code valuations. Coordinates meetings between the Academy team and external parties seeking advice on CPT/HCPCS process and code change applications.
• Researches, analyzes, and maintains numerical and statistical data, including payment and utilization data, regarding ophthalmology services in the health care systems for purposes of policy advocacy.
• Responds to requests from Specialties, State societies, Practice Management, and Clinical Education on utilization and payment policy matters.
• Monitors and coordinates response to requests for review of government and third-party payer ophthalmic policies by researching issues and working with the Health Policy Committee and practice management team on drafting responses.
• Manages relationships with ophthalmology Carrier Advisor Committee (CAC) representatives and engages them in advocacy efforts (e.g., LCD meetings) as needed.
• Develops materials and issue summaries for inclusion in Academy newsletters, Committee and Board meetings, and updates and posts information on the webpage in coordination with the Director.
• Assists with drafting the Academy’s response to federal regulations as assigned by the Director (e.g., Medicare Physician Fee Schedule, Medicare Advantage oversight, utilization management).
• Responds to member inquiries, researches specific reimbursement and other health policy issues and provides requested data and analysis.
• Works with Director to organize the annual Health Policy Committee meeting and assists with any organizational support for educational sessions at various Academy meetings, including the Academy’s Annual Meeting and Mid-Year Forum.

May include other responsibilities as assigned.

Requirements:

• Knowledge of and experience with Medicare physician payment and other healthcare regulations and systems
• Understanding of the Federal regulatory processes and familiarity with legislative process
• Familiarity with RUC survey process and CPT process
• Qualitative and quantitative skills and experience with Excel
• Strong writing skills
• Mathematical and spreadsheet aptitude necessary (i.e., updating fee schedules and other payment calculations)
• Proficiency with MS-Office Suite: Word, Excel and other database programs, PowerPoint and Outlook
• Familiarity with AMA RUC and or Code Manager Database
• Knowledge of website terminology and basic web formatting
• Ability to analyze regulatory publications and coherently distill the changes to educate practice management staff and members
• Critical thinking skills and ability to multi-task
• Ability to converse intelligently and relay information appropriately to members, outside representatives and supervisory staff
• Ability to communicate ophthalmology's positions and network with outside agencies that significantly affect ophthalmic policy
• B.A. or B.S., in a related field preferred.
• Two or more years of health care payment policy work experience in a health association, governmental agency, or the private sector dealing with Medicare, health care payment policy or other health policy issues, preferred.
• Ability to travel (i.e., Annual Meeting, approx., 7-10 days, Health Policy Meeting, approx. 2-3 days, CPT and RUC meetings six times per year for 2-3 days at a time)

Remote Work – with approval, this position is eligible for up to 3 days

Salary: $86,376