Policy Publication Specialist
Avalon Healthcare Solutions
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.
For more about Avalon, please visit our web site at http://www.avalonhcs.com.
About the Policy Publication Specialist:
The Policy Publication Specialist will be a part of the clinical operations team reporting directly to the Director of Medical Policy. As a member of the Clinical Operations Team, Policy Publication Specialist will help Avalon Healthcare Solutions to refine the way health plans, physicians, and laboratories coordinate laboratory care for millions of patients.
The Policy Publication Specialist, formulates policy plans, coordinates, and directs editorial and publication activities. Confers with executives, department heads and Medical Policy to formulate policy, coordinate activities within the department team, establish production schedules, solve publication problems and organization changes. Serves as a key contact person and coordinator to assigned clientele and performs a variety of editorial duties: plans, designs, edits and produces policy publications for clientele. Generates communication including policy adoption reports, trends and timelines.
This position is eligible for remote work, but quarterly travel to the corporate office in Tampa, Florida may be required.
Policy Publication Specialist - Essential Functions and Responsibilities:
- Conduct client medical policy reconciliation
- Meet with clients on a routine basis
- Work directly with the client and assist clients with any medical policy questions
- Support the VP, Clinical Operations in working as the liaison between the client and Avalon
- Monitor variances to AHS policy
- Formatting, updating, publishing, and archiving documents
- Keeping track of all policy changes and client variances
- Updating and maintaining documentation in Policy Rules Integrated System Management (PRISM)
- Working in collaboration with other departments
- Manage client communication
- Provide interdepartmental communication regarding policy updates
Policy Publication Specialist - Qualifications:
- Minimum 1-5 years of relevant work experience.
- Licensed Professional Nurse, Medical Technology, or related field
- Experience creating/revising medical policies and/or clinical practice guidelines within a managed care organization or similar health care environment.
- Understanding and experience working with CPT and diagnosis codes
- Understanding of process improvement principles
- Outstanding written and verbal communication skills
- Proficient computer skills (Excel, Word, Power Point, Jira, PDF creation)
- Strong general admin skills
- Strong customer service skills
- Ability to prioritize and manage multiple projects
- Fast learner
- Strong attention to details
- Strong organizational skills
- Flexible to changes and innovation
- Ability to learn new technologies
- Ability to interact effectively with counterparts at assigned clients
- Ability to interpret and synthesize complex healthcare literature and clinical information
Policy Publication Specialist - Preferred Qualifications:
- Customer service experience
- Previous health plan experience desired
- Previous experience working in a start-up or early-stage company is helpful