**Resp & Qualifications**

**PURPOSE:**
The Payment Policy Analyst will research, develop, and coordinate the distribution and maintenance of payment policies in support of corporate payment methodologies, provider contracts, claims adjudication rules, and applicable regulatory and industry standards. This role applies analytical skills and subject matter knowledge to evaluate the impact of payment policies and ensure accurate implementation. We are looking for experienced professionals to work remotely from within the greater Baltimore metropolitan area. The incumbent will be expected to come into a CareFirst location periodically for meetings, training and/or other business-related activities.

**ESSENTIAL FUNCTIONS:**

+ Performs in-depth research on topics identified as actual or potential payment policies. Evaluates CMS guidance, industry references, peer health plan policies, coding conventions, and other authoritative sources to determine appropriatene...