Sr. Manager, Analytics and Support-Oncology REMOTE

Company: Laboratory Corporation of America
Location: Westborough
Posted on: September 23, 2022

Job Description:

Basic Purpose:

The Sr. Manager Analytics and Support is responsible for supporting the Oncology Enterprise with data and workflow analysis activities for the company, including pre and post-claim adjudication strategies to assist with influencing payer policy and securing the highest level of reimbursement. The Sr. Manager will act as an internal conduit to gather and share information as it relates to billing and reimbursement results/issues, prior authorization outcomes, and payor behavior.

Duties and Responsibilities:

• Conduct complex Oncology revenue and bad debt adjustment analysis
  • Test level
  • CPT level
  • Payor level
  • Conduct Oncology Test/CPT/Diagnosis analysis
    • In collaboration with Medical Policy
    • New Oncology test and or project initiatives
    • Conduct Prior Authorization results analysis
    • Conduct appeal analysis for success/failure rate
    • Collaborate with Policy and Payor Relations, 3rd Party Analysis, Business Revenue & Support Services, Test Analysis, Test Master, etc. to obtain data/information to report trends to key franchise stakeholders across the organization
    • Collaborate with Policy/Payor Relations to help facilitate/drive/change payor policies
    • Conduct workflow and data gap analysis in all systems (internal and external) (data analysis and process flows) to ensure specimen flow/billing outcomes are as expected
      • Develop effective and efficient data mining processes for Oncology LOB for the above-stated analysis in both LCA proper and offline systems (when applicable)
      • Create data depositories/warehouses and relevant workflows for pertinent Oncology data from 3rd Party Analysis Reimbursement, Finance, Pricing Analytics, Prior Authorization, Policy Analysis, etc.
      • Create data metric summaries and dashboards to present significant findings, impacts, policy changes, etc. to key franchise stakeholders across the organization (collaboration with Project Administrator)
        • Data from internal and external data sources
        • Identify and recommend risk-reduction actions related to workflows, revenue adjustments, denials, that negatively impact reimbursement
        • Assist with reporting requests from Divisional AR Directors, BQCC's, Sales, Oncology Leadership
        • Lead communication efforts as necessary ensuring RCM is aware and abreast of oncology strategies and initiatives
        • Serve as point person collaborating and communicating with oncology sales leadership issues related to Medicare, Medicaid, & 3rd party reimbursement
        • Provide leadership with identified trends, recommended actions and results to support Win Big in Oncology
        • Understanding of Oncology/Anatomic Pathology CPT coding and associated billing rules and regulations (NCCI Edits, etc.)
        • Working knowledge of Labcorp Oncology Flagship and Precision Medicine testing offerings
        • Coordinate training and knowledge transfers between Sales, Marketing, RCM and other relevant teams
          Qualifications:
          
          Recommended:
          
          • B.A./B.S. required or
          • 5-10 years of progressive work experience in related field
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