Explore careers with our portfolio companies

Supervisor, Medical Policy and Publication

Avalon Healthcare Solutions

Avalon Healthcare Solutions

People & HR, Operations
Posted on Thursday, August 31, 2023

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 Supervisor, Medical Policy and Publication:

Reporting to the Director, Policy Operations and Enforcement, this supervisory role oversees the policy and publication operations at Avalon. This position is also responsible for maintaining client service level agreements (SLAs) through monitoring, analyzing, and reporting. This is a working supervisory role that combines both individual contributor work as well as people management skills.

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

Supervisor, Medical Policy and Publication - Essential Functions and Responsibilities:

  • Work closely and collaboratively with the Medical Policy, Translation and Coding, Configuration, Implementation, and Client Success departments to ensure that our client’s medical policies are accurately captured and published.
  • Supervise, develop, and mentor policy and publication team members.
  • Serve as a point of escalation for departmental questions; train new employees in the department; work collaboratively to educate others in the organization about policy publication.
  • Develop and draft policy documents, ensuring they are written in a clear, concise, and accessible manner for the target audience.
  • Edit and review policy publications to maintain consistency, accuracy, and adherence to company guidelines and industry standards.
  • Implement a structured review process, incorporating feedback from stakeholders, to ensure policies are comprehensive and reflective of best practices.
  • Maintain a centralized repository for policy documents and related resources, ensuring easy accessibility for all stakeholders.
  • Monitor and track changes in healthcare policies and regulations, promptly updating medical policies as needed.
  • Develop and execute effective communication strategies to disseminate policy documents to internal teams and external stakeholders.
  • Participate in cross-functional projects and initiatives, providing medical policy expertise and guidance as required.
  • Coordinate and facilitate policy training sessions and workshops to ensure employees understand and comply with policy guidelines.
  • Stay informed about emerging trends and advancements in policy publication, recommending process improvements and innovative practices.

Supervisor, Medical Policy and Publication - Qualifications:

  • Bachelor’s Degree in Business, Healthcare Administration, or related area.
  • 2 years’ experience in health care management required, ideally with a health maintenance organization or health insurance carrier.
  • 5 or more years’ experience in managed care medical policy creation, implementation, and/or publication.
  • Maintain confidentiality and comply with Health Insurance Portability and Accountability Act (HIPAA).
  • Proficient with Microsoft Office products including Word, PowerPoint, and Excel
  • Demonstrated experience in researching, drafting, and editing policy documents with a keen eye for detail and accuracy.
  • Excellent written and verbal communication skills, with the ability to communicate complex ideas in a clear and accessible manner.
  • Ability to adapt to changing priorities, tight deadlines, and handle multiple projects simultaneously.
  • A proactive and adaptable attitude, capable of thriving in a fast-paced and dynamic work environment.