Policy Analyst/Regulatory Compliance Specialist

Advanced Technologies & Laboratories International, Inc. (ATL) is hiring a Policy Analyst/Regulatory Compliance Specialist (Research Associate & Project Manager) for the National Institute for Occupational Safety and Health (NIOSH), World Trade Center Health Program.

PURPOSE

On July 1, 2011, Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH), WTC Health Program was established as a federal health care program to provide medical monitoring and treatment for eligible members in accordance with the James Zadroga 9/11 Health and Compensation Act of 2010. On December 18, 2015, President Obama signed the James Zadroga 9/11 Health and Compensation Reauthorization Act which reauthorized the WTC Health Program for 75 years, ending in 2090.

The contractor is to maintain a healthy organizational culture in providing consistent and professional communication and services to WTC Health Program clients including health care beneficiaries and health care providers, the contractor shall participate in the occasionally held lunch/learn and other training sessions regarding WTC Health Program organizational culture.

SCOPE OF WORK

The Healthcare Benefits Branch of the WTC Health Program has a need for a Policy Analyst/Regulatory Compliance Specialist (Research Associate & Project Manager) to support the clinical coverage team in tracking complex projects, conducting thorough and exhaustive literature reviews, writing medical policy, and maintaining the research/medical knowledge base.

Research and Certifications

Supports and conducts research activities involving the application of specific policies and regulations to medical conditions. Activities include but are not limited to review and summary of literature and scientific experiments, data preparation and analysis, research design, and assisting with the preparation of manuscripts.
• Conduct evidence-based research using support tools such as Up-To-Date, National Comprehensive Cancer Network [NCCN] Guidelines, PubMed/Ovid, and other library-based platforms.
• Prepares various communication materials utilizing Word, PowerPoint, Excel and other similar software for a variety of management information reports and project tracking.
• Presents analyses and associated recommendations through presentations in a variety of formats to leadership and SMEs. Applies SME/leadership feedback/decision(s) to write final proposals.
• Reviews up to 100 certifications on a weekly basis using specific Program criteria.

Project & Information Management

• Plans, develops, implements, and coordinates projects related to the Medical Benefits and Certifications Unit, and specifically the Clinical Consultation Team, of the WTC Health Program throughout the full project life cycle, -including planning, tracking milestones, implementing.
• Works across the spectrum of management, communications and operational issues to move special projects and business issues forward. Independently researches and resolves complex issues related to benefits, claim process, regulatory requirements.Analyzes CMS, Tricare, and other federal and private payor program policies and/or operational documents, coverage determinations, and research reports and applies this information to programs decisions.
• Develops and maintains knowledge management library, establishing protocol for documenting program decisions and making it searchable and accessible to staff.
• Database management including creation, maintenance/management and data entry with close collaboration with Senior Medical Officers, and other clinical staff members.
• Performs data entry and manages database as directed and performs other administrative duties related to the Healthcare Benefits Branch of the WTC Health Program as assigned.

Basic Qualifications

• Qualified candidates must have successfully completed a bachelor's degree in nursing. No New Graduates. Have and maintain an active nurse license in the US states or territories.
• A minimum of five years' experience in the health care, clinical trials and policy.
• A minimum of five years' experience in project management field.
• 5-10+ years in nursing, research experience, preferably in an academic or medical setting.
• Demonstrates project management experience. Experience in coordinating and providing support to large complex projects.
• Ability to work independently without direct supervision in a fast-paced environment, prioritizing duties and managing time efficiently.
• Ability to work both independently with limited supervision as well as in a collaborative team environment.

Preferred Qualifications

• Nurses or nurse practitioners with a master's or doctoral degree may be preferred.
• Knowledgeable in writing scientific publications, federal policy reports, and conducting in-depth research using web-based scientific libraries and research methods is preferred.
• Experience in managed health care, health insurance or federal payor models.
• Experience in leading performance improvement processes through use of industry accepted modalities, process improvement tools, and techniques (Lean, Six Sigma, PDSA, etc.) preferred.
• Advanced proficiency in MS Word, PowerPoint, Excel, and SharePoint.

PSI offers full-time, benefits eligible employees a competitive total compensation package that includes paid leave, and options for employer sponsored group medical, dental, vision, short-term and long-term disability, life insurance, AD&D coverage, legal services, identity theft, and accident insurance. Flexible spending account and health saving account options offer pre-tax savings for qualified medical, dental, and vision expenses. The company sponsored 401(k) retirement plan has an employer contribution match that is immediately vested. We invest in the professional growth of our employees through professional courses, certifications, and tuition reimbursement programs.

It is company policy to promote equal employment opportunities. All personnel decisions, including, but not limited to, recruiting, hiring, training, promotion, compensation, benefits, and termination, are made without regard to race, color, religion, age, sex, sexual orientation, pregnancy, gender identity, genetic information, national origin, citizenship status, veteran status, protected veteran status, disability, or any other characteristic protected by applicable federal, state, or local law.

Reasonable accommodations for applicants and employees with disabilities will be provided. If a reasonable accommodation is needed to participate in the job application or interview process, to perform essential job functions, and/or to receive other benefits and privileges of employment, please contact Human Resources by emailing HRDepartment@plan-sys.com, or by dialing 703-575-8400.