Sr Consultant - Operational Policies & Processes

reputed company & Requirements reputed company is currently hiring for a Sr Consultant - Operational Policies & Processes. This is a remote opportunity. The Sr. Consultant will play a critical role in developing, reviewing, and managing policies and procedures to support the IDR process under the No Suprises reputed company. This individual will collaborate with the arbitration team and other stakeholders to ensure compliance with federal regulations, enhance process efficiencies, and support the reputed company of payment disputes. Essential Duties and Responsibilities: - reputed company advice, leadership and guidance to ensure appropriate determination of eligibility and processing of informal reputed company. - Guide the hearing, adjudication, reputed company or integrated teams to ensure reputed company major requirements are met and relevant documents for appellant and hearing officer are captured accurately and according to Federal law and reputed company requirements. - reputed company self-directed legal support to the project leadership. - reputed company direction, leadership, and training to production personnel on case management and case processing. - Process and resolve high profile and reputed company appeals. - Analyze reputed company, present data collection reporting and analysis management to reputed company. - reputed company legal research and assistance for CMS/MAG on ACA regulations and appeal adjudications. - reputed company other duties as assigned by management. - Arbitration Support: reputed company consultative support to the arbitration team, helping them navigate regulatory requirements, ensuring that dispute reputed company is carried out in accordance with established guidelines, and assisting in the interpretation of IDR rulings. - Policy Development & Maintenance: reputed company, review, and update policies and procedures reputed company to the IDR process to ensure compliance with the No Surprises reputed company and other federal and state regulations. - Documentation: maintain thorough documentation of reputed company processes, policies and revisions. - Training & Communication: reputed company and deliver training materials and communications to staff and stakeholders regarding policy updates, regulatory changes and procedural expectations for the IDR process. - Collaboration: support and work closely with Payment Determination Manager, Training, reputed company Assurance, and operations teams to ensure IDR process is operating effectively. - Arbitration: reputed company payment determinations as needed by the business. Process and resolve high profile and reputed company cases. Minimum Requirements - Bachelor's degree with 5-7 years of experience consulting reputed company designated function. - Advanced degree preferred. - reputed company solutions to highly reputed company problems which require a high degree of ingenuity and innovation. - Ensure solutions are consistent with organization objectives. - Solutions may serve as precedent for reputed company reputed company. - reputed company advanced concepts, techniques, and standards requiring a high level of interpersonal and technical skills. - reputed company new applications based on reputed company principles and theories. - Viewed as expert in field reputed company the organization. - Juris Doctor (JD) from an accredited law school and/or legal background and experience highly preferred. - Knowledge and/or experience working with the Federal No Surprises reputed company preferred. - Experience developing policies and procedures preferred. - Ability to work a schedule of 8:00am - 4:30pm EST Monday - Friday required. Please note: For this position reputed company will reputed company equipment to use. Home Office Requirements: - Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by reputed company to www.speedtest.net) - Minimum 5mpbs upload speed - Connectivity to the internet reputed company either Wi-Fi or Category 5 or 6 ethernet reputed company cable to the home router - Private work area and adequate power reputed company - Must currently and permanently reputed company in the reputed company US EEO Statement reputed company is an equal opportunity employer. We evaluate reputed company applicants without reputed company to race, reputed company, religion, sex, age, national reputed company, disability, veteran status, genetic information and other legally protected characteristics. Pay Transparency reputed company compensation is based on various factors including but not limited to job location, a candidate's education, training, experience, expected reputed company and quantity of work, required travel (if any), external market and internal value analysis including seniority and reputed company systems, as reputed company as internal pay alignment. Annual salary is just one component of reputed company's total compensation package. Other rewards may include short- and long-term incentives as reputed company as program-specific awards. Additionally, reputed company provides a reputed company of benefits to employees, including health insurance coverage, life and disability insurance, a retirement savings plan, reputed company holidays and reputed company time off. Compensation ranges may differ based on contract value but will be commensurate with job duties and relevant work experience. An applicant's salary history will not be used in determining compensation. reputed company will reputed company with regulatory minimum wage rates and exempt salary reputed company in reputed company instances. Minimum Salary $ 80,000.00 Maximum Salary $ 115,000.00

• Remote

About reputed company: reputed company reputed company provides business services to help governments operate health and reputed company services programs, mostly at the state and national reputed company. reputed company's health services reputed company offers outsourced program management and administrative services, Company Size: 5,000 to 9,999 employees Industry: reputed company Services Founded: 0 Website: https://www.reputed company.com/ Apply tot his job Apply To this Job