Policy and Disputes Analyst

Policy and Disputes Analyst – PKH Enterprises is looking for several candidates to join our team to perform in the role of Policy and Disputes Analyst, supporting a government client that utilizes the National Practitioner Data Bank (NPDB). The Policy and Disputes Analyst will provide governance and health care policy support. Using the NPDB, the analysts will provide time-sensitive support to help evaluate disputes involving accuracy and reportability in accordance with applicable NPDB laws and regulations. This opportunity offers a hybrid work environment and candidates must be able to commute to Rockville, Maryland, for occasional onsite work with the government client.

Responsibilities:

·       Analyze healthcare related scenarios and determine relevant facts to develop a dispute resolution analysis.

·       Gather additional information, as needed, from healthcare organizations and practitioners to assist in resolving disputes.

·       Maintain portfolio of cases, monitoring the progress and milestones, and reporting status to dispute resolution managers.

·       Compose written deliverables for the client that include dispute resolution analysis and requestions for additional information.

·       Attention to detail. Review disputed reports and documentation to determine if sufficient information exists to determine reportability and accuracy.

·       Compose correspondence letters to include dispute resolution analysis, requestions for additional information, and responses to high-level inquiries from Congress and other federal and state government agencies.

·       Consult with dispute resolution managers for advise on all matters pertaining to the resolution of disputed reports and see legal opinions from the agency counsel.

·       Work closely with federal staff through iterations of decision letter revisions.

·       Assist in compliance efforts by auditing adverse actions and reports submitted by state licensing boards.

·       Experience prioritizing and completing multiple, concurrent, time-sensitive tasks. Must review multiple dispute cases simultaneously and prioritize assignments and tasks, accordingly, remaining flexible to changing priorities and new initiatives.

Requirements:

·       Must have 3-6 years of relevant work experience; bachelor’s degree.

·       Extensive experience in written communication with the ability to write succinctly and explain complex situations in plain English.

·       Experience in customer service and customer satisfaction. Must be able to appropriately handle telephone calls and written inquiries from a variety of stakeholders, including healthcare practitioners and organizations, legal counsel for all parties, government agencies, and congressional staff.

·       Proficiency with Microsoft Office.

·       Eligible candidates must be able to obtain and maintain a security clearance.

Preferred:

·       Master’s degree

·       Experience in legal writing and legal analysis. Must evaluate complex issues to determine if the disputed report is reportable and accurately submitted in accordance with applicable laws and regulations.

·       Paralegal and/or policy compliance experience helpful.