We are the American Academy of Sleep Medicine, an innovative professional medical association located in Darien, IL, a southwest suburb of Chicago. We're looking for a Health Policy Manager to be our resident expert in navigating through the ever-changing health care regulations and policies (CMS, private payer, federal, state) to develop sound strategies for the advancement of the sleep medicine field. This person will also foster collaborative relationships and strategic partnerships with private and public payers to educate them about the sleep medicine field and ensure policies are patient-centered and consistent with our clinical practice guidelines, policies and other resources.
You have a strong knowledge of the insurance field on the payer side OR medical policy &/or billing knowledge through experience in a healthcare system. You have a pulse on health care trends, legislation and regulations and can apply that knowledge for the benefit of others in the sleep medicine field.
What You’ll Do
Cultivate relationships with insurance companies, benefit management companies and other payers to address coverage gaps specific to sleep practices. Advocate for fair and appropriate coverage by educating key players on corresponding underwriting practices which meet our members’ needs.
Provide analyses of, and monitor developments in, the health care and sleep medicine markets, specifically the intersection of regulation and policy with medical practice.
Serve as the primary staff representative to the AMA RUC and CPT - facilitating physician participation in the process of creating new codes for sleep medicine, recommending appropriate values for sleep services and developing resources to educate members about changes to codes or valuations.
Serve as point person for projects related to the evolving healthcare climate including: alternative payment models and the Medicare Quality Payment Program
Study health care trends, proposed legislation and healthcare regulations, and develop strategies on how the organization responds to new regulations and future market needs in sleep medicine
Provide data, information and reporting on a wide range of issues related to the insurance marketplace, including regulatory and policy developments.
Summarize findings and research in written products of various types, including tables, charts, short summaries, as well as longer analytical policy memos and reports.
Lead and contribute to the development, production and preparation of economic analyses, written materials, including briefing or issue papers, and memoranda for leadership.
Present data and reports to stakeholders and members in private meetings and at national conferences.
Nationwide travel approximately once a month, which may include weekends
What we need:
Bachelor’s degree in business administration, health administration, public health or related field
Minimum five years of experience in the insurance field on the payer side or experience in a healthcare system with strong medical policy and/or billing knowledge
Minimum 2 years of management/supervisory experience
Dynamic and persuasive written and verbal communication skills
Knowledge of health care/insurance industry, trends, regulations (e.g., Affordable Care Act) and future market needs
Knowledge of alternative payment models and value-based care
Strong critical thinking with the ability to summarize technical information and communicate key details in a user-friendly manner
Ability to cultivate relationships, work effectively and negotiate with insurance companies
Ability to manage and coordinate multiple projects at one time; strong organizational skills required
What we’d love:
Prior experience in a medical or health care association
Master’s degree in economics, health policy, public health or related field
Aside from the great job opportunity, we also have amazing benefits.
Affordable medical & dental coverage for you and your family
Free life & disability insurance
3 weeks of PTO (personal/vacation/sick time) plus paid company holidays
The American Academy of Sleep Medicine (AASM) office in Darien, IL (a southwest suburb of Chicago) is conveniently located nearby major expressways. Established in 1975, the AASM is a professional, forward thinking membership organization dedicated to the advancement of sleep medicine and related research. The AASM’s mission is to assure quality care for patients with sleep disorders, promote the advancement of sleep research and provide public and professional education. The AASM represents the professional interests of over 8,000 sleep medicine clinicians and researchers worldwide and accredits thousands of sleep centers in the United States.
Additional Salary Information: Salary commensurate with experience.
Internal Number: 201810
About American Academy of Sleep Medicine
Established in 1975, the American Academy of Sleep Medicine (AASM) is a professional membership organization dedicated to the advancement of sleep medicine and related research. The AASM’s mission is to improve sleep health and promote high quality patient centered care through advocacy, education, strategic research, and practice standards. The AASM represents the professional interests of over 8,500 sleep medicine clinicians and researchers worldwide and accredits thousands sleep centers in the United States.
From insomnia to sleep apnea, the AASM considers sleep disorders an illness that has reached epidemic proportions. Board-certified sleep medicine physicians in an AASM-accredited sleep center provide effective treatment. AASM encourages patients to talk to their doctors about sleep problems or visit www.sleepeducation.com for a searchable directory of sleep centers.