Jobs

CAQH, a nonprofit, Washington, D.C.-based alliance of health plans and trade associations working to simplify healthcare administration, is currently seeking qualified candidates for the following position supporting its CORE and UPD initiatives.

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Director, Research and Measurement – Provides successful oversight of the transition to CAQH of; and the day-to-day and strategic long-term management of, the US Healthcare Efficiency Index (Efficiency Index). Also management of other related CAQH measurement initiatives. Promotes CAQH value to its members and enhances its reputation as a thought-leader and trend setter in the area of administrative simplification. Serves as a senior advisor to the CAQH management team.

• Bachelor's degree + MS degree with an emphasis on statistics, informatics, or related field required. Ph.D. desirable.
• Seven or more years experience, preferably in a health services research environment, a corporate setting or with an academic institution.
• Five or more years experience in managing staff, consultants or outside vendors.
• Demonstrated leadership competencies with the ability to collaborate with others and establish working relationships, communicate effectively across the organization and at different levels, coordinate multiple work efforts, and translate business needs into practical applications and solutions.
• Proven ability to write and present, in small and large venues, clear and concise reports which contain complex data and concepts.
• Three or more years in successfully managing complex, multi-stakeholder projects desired.

Manager, CORE Education, Outreach and Participant Relations - The Manager of Education, Outreach and Participant Relations will plan and manage the CORE education and participant relations activities. Working with the CORE Managing Director, the Manager is responsible to ensure all education, participant relations and outreach activities are aligned with the CORE strategic imperatives, with an emphasis on rule writing, certification and testing, and coordination with other industry efforts. This position will promote, enhance and build the reputation of CORE as the first national heathcare administrative operating rules author and aim to ensure the industry has accessible information regarding the newly mandated operating rules. The Manager will work closely with the CAQH Communications staff, CORE rule writing staff and external consultants to ensure a smooth, seamless transfer of accurate presentation materials.

• Bachelor’s degree required. Master’s degree in a related field is desirable.
• Ten or more years of educational experience, preferably in cross-industry environments and healthcare financial transactions; including at least three years managing staff and five or more years managing, creating, coordinating or integrating technical information using a range of educational tactics into participant training materials and outreach tools.
• Three or more years managing aspects of membership-driven outreach activities.
• Awareness and ongoing application of HIT issues will be essential. Knowledge of HIPAA-transactions is strongly preferred.
• Prior work involving education and outreach related to regulatory compliance is also preferred.

Director of CORE Rule Development - The Director of CORE Rule Development will successfully direct the CORE rule writing activities and, working with the CORE Managing Director, ensure all rule writing activities are aligned with CORE’s other strategic imperatives such as outreach/collaboration, certification and alignment with ACA goals. The position will aim to enhance the reputation of CORE as the first national healthcare administrative operating rules author as well as an effort devoted to building industry trust through the creation of real-world-based operating rules. Attention to and awareness of HIPAA-related regulatory issues will be essential.

• Bachelor’s degree is required. Master’s degree is desirable.
• Ten or more years of project management experience, preferably in cross-industry environments and healthcare financial transactions. With at least three or more of those years spent on successfully managing complex or multi-stakeholder projects.
• Five or more years successfully managing staff and technical consultants, including budget oversight and integration of technical skills.
• Experience with business process improvement and business case development.
• Knowledge of the healthcare health information technology (HIT) environment.
• Basic knowledge of HIPAA transactions and/or direct experience with executing healthcare revenue cycle in a real-world setting.
• Exposure to managing regulatory compliance desirable.

Please submit resume, cover letter and salary requirements to hr@ahip.org

CAQH
601 Pennsylvania Avenue, NW
South Building, Suite 500
Washington, DC 20004