Reference Code: HPPS
The American Academy of Physical Medicine and Rehabilitation (AAPM&R), the premier professional association for rehabilitation physicians, has an immediate opening for a Manager, Reimbursement & Regulatory Affairs.
AAPM&R serves more than 8,000 board certified physicians who specialize in physical medicine and rehabilitation (one of 24 ABMS certified board certified medical specialties).
This position serves as an expert in health care reimbursement policy and regulation, with an understanding of their implications for physician practice on the state and national levels, to develop and implement AAPM&R’s reimbursement and regulatory affairs agenda and activities. The Manager will serve as lead staff for the Academy’s Reimbursement and Policy Review Committee, which includes supporting Academy representatives on the AMA Specialty Society Relative Value Update Committee (RUC) and CPT Editorial Panel, and providing content expertise to enhance relationships and advocacy with government agencies, including CMS, and legislative staff. The position also assists members with coding and reimbursement inquiries and oversees content for relevant educational courses and articles, including workshops and webinars. The overall goal is to help physician members prepare for and adapt in today’s heavily regulated health care environment. Knowledge of current regulations, including MACRA, and excellent written and verbal communication skills are essential.
Essential Duties and Responsibilities:
The Manager, Reimbursement and Regulatory Affairs, is expected to be an in-house expert on reimbursement and practice regulation issues and someone who can lead AAPM&R related policies and activities. The position requires a strong and enthusiastic voice for the importance and relevance of reimbursement and health care changes for rehabilitation physicians and for staff. The ideal candidate will educate AAPM&R members about the urgent implications of developing trends and help them prepare for impending changes in their practices.
- Serve as staff lead to the Reimbursement and Policy Review Committee, partnering with the Chair to establish a reimbursement and regulatory strategic plan and guide committee projects to successful completion, overseeing meetings/conference calls, and preparing meeting agendas and minutes. Also, provide necessary support or expertise to other committees, including the Quality, Practice, Policy and Research and Practice Preparedness Committees, and task forces as needed.
- Educate AAPM&R leaders and members on reimbursement policy, regulation, and related practice management issues; assure appropriate and timely communication of department activities within the organization, to the Board of Directors, Council leaders, members, and outside entities. Responsible for providing relevant and current articles and updates in the Academy’s monthly newsletter, The Physiatrist, as well as in the weekly Connection electronic newsletter, and on the AAPM&R website.
- Direct AAPM&R RUC and CPT activity to ensure effective representation for physical medicine and rehabilitation; attend relevant meetings (e.g., CMS, AMA); and form relationships with key stakeholders and counterparts.
- Analyze and develop comments regarding all relevant Medicare Part A and B physician reimbursement issues, including, but not limited to, proposed and final CMS regulations, proposed CPT code and RBRVS physician work value changes, and practice expense value developments; prepare AAPM&R position statements as needed.
- Work closely with Health Policy and Practice Services team members and Academy designated lobbyists regarding strategic response to federal regulatory activities that have potential impact on rehabilitation specialists. Prepare formal Academy response with necessary Academy leaders.
- Direct communication with members regarding reimbursement, regulatory and practice management agenda and strategies. Create and implement related membership surveys, as appropriate, perform data aggregation, and submit reports with recommendations.
- Lead a cross-department team to plan, organize, and implement workshops/webinars that address coding and billing and regulatory issues for rehabilitation specialists.
- Oversee the development, publication, and updating of the Academy’s coding resources and other related practice deliverables as designated.
- Serve as principal staff resource for members with concerns, comments, or questions about the Academy’s activities and policies on reimbursement and practice issues.
- As a Manager, serve as a leader with general management responsibilities, including budgeting.
- Perform other duties as assigned by the Associate Executive Director of HPPS, and the Executive Director.
Required Knowledge, Skills, and Abilities:
- Ability to effectively develop and implement strategic long term plans and programs related to physician reimbursement, Medicare regulations, and the implications of health care reform on physician practices.
- Excellent ability to organize and clearly communicate information and ideas, including sometimes confusing health care jargon.
- Superior interpersonal skills, including the ability to work productively with physicians and colleagues from other organizations.
- In depth understanding of CPT Editorial Panel and RUC processes, including code change proposal and relative value unit survey development, implementation, and data analysis.
- Ability to effectively collaborate within and across departments in order to achieve both departmental and organizational goals.
- Self-motivated with the ability to balance and direct multiple projects.
- Maintain high professional standards of integrity, ethics, and commitment to the goals of AAPM&R.
Education and Experience:
- Bachelor’s degree in a health policy, health care economics, or public policy related field, and/or a clinical or advanced degree in a related field preferred. Experience with physician billing and coding, such as CPC or AHIMA certification, is desirable.
- Three or more years of direct experience working in health care systems, health policy and/or physician reimbursement, preferably with a medical specialty society, health insurance company, hospital, rehabilitation organization, or physician practice. Previous experience with CPT Editorial Panel and RUC processes highly desirable.
- Knowledge of healthcare reform, including MACRA implementation, healthcare insurance issues, and healthcare policy.
- Excellent oral and written communications skills, proven interpersonal and team skills and ability to work in a multi-disciplinary environment. Written and spoken fluency in English required.
- Computer proficiency with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook) and proficiency in navigating and mining Internet resources.
- Demonstrated experience working effectively with physicians.
10-15% annually, including weekend committee meetings.
How to Apply for a Job with AAPM&R
Submit your cover letter, resume, salary history, and position of interest to: firstname.lastname@example.org
. Please note, you must include the position's reference code HPPS in the email's subject line to be considered.
No faxing or phone inquiries please.
AAPM&R offers an excellent work environment, competitive salary, and a very comprehensive benefits package. Additionally, we are an Equal Opportunity Employer (EOE).