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Payer Management Analyst

Company: Livongo Health, Inc.
Location: Lewisville
Posted on: November 18, 2021

Job Description:

The Opportunity Teladoc Health is transforming how people access and experience healthcare. Recognized as the world leader in virtual care, we are partnering with over a thousand clients to serve hundreds of thousands (soon millions!) of people living with chronic conditions every day. Teladoc Health offers a whole person virtual care platform that empowers all people everywhere to live their healthiest lives by transforming the healthcare experience, from acute and primary care to chronic care, mental health, and specialty care. Our team of data scientists aggregate and interpret substantial amounts of health data and information to create actionable, personalized, and timely health signals for our members. This approach delivers better clinical and financial outcomes while creating a different and better healthcare experience for people everywhere. Under the general direction of the Director, Payer Management, the Payer Management Analyst will serve as the operational subject matter expert (SME), and work directly with health plans, responsible for managing Teladoc Health's relationship with health plans. This may include fee schedule negotiations and reimbursement strategies, member eligibility, benefit administration, provider network management (including participating provider agreements) and billing/claims-related payment issues. This position will also collaborate with internal departments to understand potential changes to telehealth reimbursement and provide support to evaluate proposed changes and the impact on the existing health plan relationships. This position will also collaborate with Revenue Cycle Management/Finance and Provider Operations to ensure telehealth services are accurately and timely reimbursed according to contract. The ideal candidate will: * Have expert understanding of the complexities of payer eligibility and reimbursement arrangements, value-based care, and benefits administration for Medicare FFS and Medicare Advantage, Medicaid FFS and Managed Care, and Commercial payers (HMOs, PPOs) * Have strong leadership skills and a strategic mindset to understand the potential implications and impact of payer management issues on telehealth program decisions * Be highly collaborative, customer-centric, resourceful, and responsive working in a fast-paced and evolving policy and reimbursement landscape for telehealth Responsibilities * Independently perform payer reimbursement data analysis, AR analysis, and ad hoc reports for the Payer Management Team * Obtain, document, and have a detailed knowledge of payer relationships including onboarding requirements and specialized client needs * Research and develop benefit setup, accumulators, and override policies * Intake internal partner requests and perform independent research * Collaborate with Revenue Cycle Management, Payer Relations and Credentialing as appropriate * Analyze new payer contracts * Detailed knowledge of payer policy guidelines, payer management and claims processes * Work with clients and internal partners to answer inquiries and resolve account issues * They will work Subject Matter Experts and management from the following Teladoc teams to maximize payer relationships, processes, and revenue: * Credentialing * Sales and Account Management * Client Implementations * Sr. Benefit Analyst * Client Benefit Associates * Finance * Data Transfer * Revenue Cycle Management * IT & Information Management * Other Strategic Projects cross-functional business owners (e.g., Salesforce, Salesforce to Admin, Admin to AX, RTE) * Performs payer audits and, monitors Payer Management issues * Proactively manage and prioritize analysis and facilitation activities. This includes managing outstanding tickets to ensure they are up to date to and current. * This position requires a knowledge of Teladoc's Whole Care Solutions, products, and services Candidate Profile * Motivated self-starter and excellent time management * Written and oral communication skills as appropriate to effectively communicate the needs of the business and clients * Strong critical thinking and business judgement to use logic to identify issues, alternative solutions, and approaches to drive accurate conclusion to complex problems * Detail oriented, organized, and flexible individual that can perform multiple tasks with varying priorities * Effective Listening for complex communications from providers, clients, and internal partners * Experience working with business users, technical teams as well as payers * Expertise in relevant business software and Windows environments (Excel, PPT, Word, Visio) * Successful in multi-tasking * Ability to use Teladoc's resources to research complex Payer issues * Quality Focused * Team Oriented Impress us even more: * Bachelor's degree * 3-5 Experience with various healthcare structures (Medicare, Medicaid, HMO and PPO * Experience in Telehealth Why Join Teladoc Health? A New Category in Healthcare: ?Teladoc Health is transforming the healthcare experience and empowering people everywhere to live healthier lives. Our Work Truly Matters: Recognized as the world leader in whole-person virtual care, Teladoc Health uses proprietary health signals and personalized interactions to drive better health outcomes across the full continuum of care, at every stage in a person's health journey. Make an Impact: In more than 175 countries and ranked Best in KLAS for Virtual Care Platforms in 2020, Teladoc Health leverages more than a decade of expertise and data-driven insights to meet the growing virtual care needs of consumers and healthcare professionals. Focus on PEOPLE:? Teladoc Health has been recognized as a top employer?by numerous media and professional organizations. Talented, passionate individuals make the difference, in this fast-moving, collaborative, and inspiring environment. Diversity and Inclusion:??At Teladoc Health we believe that personal and professional diversity is the key to innovation. We hire based solely on your strengths and qualifications, and the way in which those strengths can directly contribute to your success in your new position. Growth and Innovation:? We've already made healthcare yet remain on the threshold of very big things. Come grow with us and support our mission to make a tangible difference in the lives of our Members. As an Equal Opportunity Employer, we never have and never will discriminate against any job candidate or employee due to age, race, religion, color, ethnicity, national origin, gender, gender identity/expression, sexual orientation, membership in an employee organization, medical condition, family history, genetic information, veteran status, marital status, parental status or pregnancy (including breastfeeding - we have a mother's room in both our offices). In our innovative and inclusive workplace, we prohibit discrimination and harassment of any kind.

Keywords: Livongo Health, Inc., Lewisville , Payer Management Analyst, Executive , Lewisville, Texas

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