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Regulatory Government Program Analyst (Healthcare)

Avalon Healthcare Solutions

Avalon Healthcare Solutions

IT, Legal
Posted on Saturday, August 5, 2023

About the Company:

Avalon Healthcare Solutions, headquartered in Tampa, Florida, is the world’s first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans across the country, the company covers more than 36 million lives and delivers 7-12% outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Platform that captures, digitizes, and analyzes lab results in real time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and driving down overall cost.

Studies show that 30% of clinical laboratory testing is unnecessary or overused. Inappropriate testing or missing a key screening can lead to complications and expense arising from unwarranted care, or not obtaining proper care when needed, leading to increased health risks and costs. Avalon helps ensure delivery of the right test, at the right time, and in the right setting. We seek to ensure the most effective patient treatment, improve clinical outcomes, and optimize cost and affordability.

Avalon is a portfolio company of Francisco Partners, a global private equity firm that specializes in investments in technology and technology-enabled service companies.

Avalon is a high growth company where every associate has an opportunity to make a difference. You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com.

Avalon Healthcare Solutions is proud to be an equal opportunity employer including disability/veteran. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.

Avalon Healthcare Solutions provides and maintains a drug-free workplace for its employees.

About the Regulatory Government Program Analyst (Healthcare)

Reporting to the Vice President, Government Programs, the Regulatory Policy Specialist will be working with a cross-functional team of stakeholders that are responsible for the timely review of regulations and guidelines for Medicare and Medicaid programs to ensure a common understanding of impact on Avalon policies.

This position is eligible for remote work, but quarterly travel to the corporate office in Tampa, Florida may be required.

Government Program Analyst (Healthcare) - Essential Functions and Responsibilities:

  • Ensure that the application of Avalon laboratory policies is not more restrictive than benefit outlined in published federal and state guidelines.
  • Maintain and publish documentation of all policy impacts to support business needs.
  • Serve as a subject matter expert for all government program policy impacts across the Avalon organization including Business Development, Client Implementation, Client, Management, Medical Policy, and Medical Economics.
  • Serve a member of the internal core implementation team.
  • Assist with internal policy interpretation and translation guidelines.

Government Program Analyst (Healthcare) - Qualifications:

  • 3-5 years professional work experience in a fast-paced environment
  • Bachelor's degree or relevant, equivalent work experience
  • Experience in working with government-mandated benefits including NCDs, LCDs, and state Medicaid guidelines; preferably as they relate to outpatient laboratory testing
  • Intermediate knowledge of Microsoft Excel, Microsoft Word, and SQL
  • Proven analytical, follow-up, and communication skills
  • Designated ability to act as a team player with a willingness to work cross functionally to create innovate, scalable solutions to problems that are effective and efficient
  • Experience providing thorough, detailed research and responding to client inquiries timely and accurately.
  • Ability to work collaboratively with cross-functional team ensuring that deliverables are timely and accurate
  • Excellent interpersonal and negotiation skills
  • Proven ability to perform in a client-facing role

Government Program Analyst (Healthcare) - Preferred Qulaifications:

  • Coding certification and applicable clinical experience is strongly preferred.