Massachusetts Jobs

78202BRJob Posting Title:Payment Policy & Advocacy Sr. Advisor (Government Relations)Department:Child Advocacy-Government RelationsAutoReqId:78202BRStatus:Full-TimeStandard Hours per Week:40 Job Posting Category:AdministrationJob Posting Description:This Payment Policy & Advocacy Sr. Advisor is responsible for...

• Leading the development and execution of patient specific advocacy to ensure complex patients locally and nationally have access to high quality care at BCH. Working with clinical and operational staff to coordinate information and process for advocacy with senior leaders at Managed care plans and Medicaid agencies.

• Maintaining relationships with MA/New England Medicaid agency staff, planning and executing meetings with leadership on a regular cadence to review services provided and rates of payment for services by the hospital and the physician’s organization.

• Managing emerging public policy and budget issues at the New England regional level. Analyzing the impacts of the policies and budget items on the enterprise from an operational and financial perspective. This includes the ability to examine managed care contracts and payor regulations that may impact the markets in these states. Ensuring that the priorities of key internal and external stakeholders are reflected in the Proactively develops strategies to influence and advocate on behalf of the populations served and the business interest of the enterprise.

• Supporting regional and national growth teams by understanding strategies and working to overcome challenges. This includes educating and standardizing processes for referring physicians, supporting the advancement of our centers of excellence and supporting Medicaid contracting strategy and renewals to improve overall margin for the enterprise.

• Government Relations designee supporting internal work with out of state practice issues like enrollment, credentialing and telehealth working closely with the office of the general counsel.

• Liaison with Divisions of Insurance and Hospital Associations on Payer related matters including meetings and workgroup.

To qualify you must have…

• A Bachelor's Degree and 7-10 years experience is required/ Master's Degree (preferred)

• Required experience in healthcare reimbursement, payment policy, or advocacy roles, preferably in a complex healthcare institution or a large payer organization. Strong knowledge of healthcare reimbursement models, third-party payors, and government programs (e.g., Medicaid). Familiarity with regulatory compliance requirements and current healthcare legislation

• Proficiency in analyzing and interpreting internal and external data to summarize for leadership-level audiences

• Excellent communication skills, both written and verbal, with the ability to influence and present complex concepts to diverse audiences

• Demonstrated experience in managing relationships across a number of constituencies, including payors and regulatory agencies

• Strong organizational skills, with the ability to prioritize multiple projects and initiatives effectively. Proven ability to work collaboratively in interdisciplinary teams and navigate complex organizational structures

​​​​Boston Children’s Hospital offers competitive compensation and unmatched benefits, including an affordable health, vision and dental insurance, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition Reimbursement, cell phone plan discounts and discounted rates on T-passes (50% off). Discover your best.

Office/Site Location:BostonRegular, Temporary, Per Diem:Regular Remote Eligibility :Part Remote/Hybrid