Director of Health Policy

The Director of Health Policy is responsible for monitoring and influencing all reimbursement, and Medicare regulatory policy at the federal level that affect ophthalmologists in the United States. Develop and implement Academy strategy regarding regulatory and Medicare payment policy, CPT/ billing code valuation, other reimbursement issues as well as federal activities related to Medicare Physician quality performance and EHR issues at CMS and ONC. Supervise two health policy staff members. Responsibilities: Develop strategies and provide leadership as well as maintain knowledge base related to Medicare Policies and private plan payment policy including, drafting and filing comments. Identify opportunities and advance the Academy’s agenda through the regulatory process. Act as a Spokesperson on reimbursement and other health policy issues for the Academy. Serve as primary staff for the Health Policy Committee. Oversee the Carrier Advisory Committee, the Academy’s RUC, PEAC and CPT activities. Supervising/conducting surveys to defend reimbursement values and develop practice expense recommendations. Develop strategies and proposals for outside contracts with outside legal counsel and consultants and manage those contracts and activities. Maintain trust and influence external policy staff, federal agency officials, consumer groups, consultants, medical societies, AMA, MedPAC and Academy members to promote the Academy’s agenda (improve payment and policy for ophthalmologists). Direct Academy communications to members on Medicare and other payment issues through various mediums including: written communications; Academy print and electronic publications; etc. in order to demonstrate the effectiveness of the Academy’s efforts. Oversees day-to-day operations of the department, providing supervision and guidance to staff (Manager, Quality and HIT Policy and Health Policy Specialist). Assures responsible development and management of the department budgets Requirements: Substantial expertise in Medicare payment policy Substantial supervision experience Capability in spreadsheet analysis and development Substantive understanding of CPT coding policy as well as AMA (RUC and PEAC) code valuation processes Substantive knowledge of federal health care statutes and regulatory process Knowledge of CMS Quality programs and initiatives as well as ONC EHR programs and regulations Understanding of private insurance and other health plan activities to identify opportunities for interaction and other opportunities to influence their policies Ability to develop and implement broad, long term programs and projects Ability to successfully manage people to maintain a good working atmosphere and reduce turnover Ability to effectively communicate with contacts inside and outside of the Academy. Ability to effectively communicate with and be responsive to the needs of all Academy members Ability to accomplish multiple priorities and meet short deadlines Ability to travel and attend weekend meetings Degree required. Current COVID vaccination required Remote – with manager approval, this position is eligible for up to 3 remote work days per week