About Avalon Healthcare Solutions:

Avalon Healthcare Solutions 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 nationwide, the company covers over 44+ million lives and delivers 10-20% proven outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Program 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 costs.

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.

Avalon has years of expertise in managing lab benefits and now is leveraging digitized lab results to drive quality clinical outcomes and proven savings. When you look at how we bring this to life, we offer Lab Insights solutions that work together to arm you with critical lab-driven insights to accelerate your value-driven care success. This is the first-of-its-kind suite of solutions to help you achieve the Triple Aim of improving the patient experience of care, improving the health of populations, and reducing the per-member cost of healthcare.

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.

About the Policy and Publication Specialist:

The Policy and Publication Specialist team member is part of the Policy Operations and Enforcement Team reporting directly to the Policy and Publication Manager. The Policy and Publication Specialist is responsible for managing the distribution and publication of medical policies, including formatting, editing, and ensuring accuracy and clarity of information by collaborating with internal stakeholders to align Policy Operations and Enforcement updates with client medical policy requirements.

This position is eligible for remote work, but quarterly travel will be required to Avalon's corporate office located in Tampa, Florida.

Policy and Publication Specialist - Essential Functions and Responsibilities:

• Collaborate with internal stakeholders supporting quarterly medical policy maintenance activities.
• Edit and proofread revised client medical policies to ensure accuracy and consistency of prior/current client policy language/decisions.
• Communicate medical policy updates clearly to clients and respond to inquiries regarding medical policy interpretation and implementation.
• Manage the publication process, including uploading content to online platforms.
• Collaborate with cross-functional teams to align client decisions with coding, translation and configurational requirements.
• Collaborate with other departments to proactively seek client medical policy decisions.
• Collaborate with Implementation Team by facilitating medical policy reconciliation meetings with new clients. Traveling to client location required.
• Remote workers are required to travel to Avalon’s Tampa office for quarterly in-person meetings when scheduled.
• Engagement in the creation and transition of IT ticketing system to support transitioning workflow.
• Maintain and update data resources to ensure accurate and reliable reporting.

Policy and Publication Specialist - Qualifications:

• 1-3 Years relevant work experience
• Bachelor’s Degree or equivalent work experience
• Experience creating/revising policies, standard operating procedures and/or guidelines within a managed care organization or similar health care environment.
• Understand and experience working with CPT codes and diagnosis codes.
• Understand process improvement principles.
• Outstanding written and verbal communication skills.
• Proficient computer skills (Excel, Word, Power Point, Jira, PDF creation).
• Strong organization skills and ability to prioritize and manage multiple projects.
• Flexible and ability to learn new technologies.
• Ability to interact effectively with counterparts and assigned clients.
• Ability to interpret and synthesize complex healthcare literature and clinical information.

Policy and Publication Specialist – Preferred Qualifications:

• Previous health plan experience desired.
• Experience with medical terminology (CPT code and diagnosis codes).
• Previous experience working in a start-up or early-stage company is helpful.

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