Job Description

Job Description

Job Description

Salary:

DEPARTMENT Medical Economics

BASIC FUNCTION

Oversee, manage, and facilitate physician-led medical economic policy for TMA physicians. This involves identification of relevant issues in medical practice viability and development of respective policy, resources, and physician education. Foster and manage relationships with the Centers for Medicare & Medicaid Services (CMS), private insurers, Medicaid carriers, and Texas Department of Insurance and similar organizations to orchestrate collaborative efforts to support the successful operations of medical practices in Texas.

In cooperation with other TMA Divisions and the General Counsel, assess state and federal regulations that have a direct economic impact on medical practice and educate TMA members on such regulations. Track state budget, legislation, and develop physician testimony on key medical economic priorities.

MAJOR RESPONSIBILITIES/TASKS

1. Maintain and develop strategies and support services that help physicians thrive in a variety of practice settings.
2. Plan and conduct research, perform expert-level policy reviews/analyses and develop staff recommendations and reports to aid relevant TMA Boards, Councils, and Committees in the development of proposed TMA House of Delegates policy related to medical economics and/or practice viability.
3. Maintain a comprehensive and expert-level knowledge base on policy issues and developments at the state and federal level related to medical economics and physician practice viability, including state and federal public and private payor, billing and coding issues.
4. Proactively strategize, research, develop, and analyze methods of addressing challenges Texas physicians face related to medical economics and practice viability issues.
5. Coordinate and monitor relationships between physician practices and private and public third-party payors.
6. Work collaboratively across TMA divisions and departments to plan and direct TMAs medical economics activities.
7. Work collaboratively across the state with County Medical Societies, State Specialty Societies, and all appropriate TMA Boards, Councils and Committees to plan and direct TMAs medical economics legislative activities.
8. Work collaboratively with TMA Public Affairs, Office of the General Counsel, and Marketing/Communications staff to aid in the strategic planning of TMAs legislative activities related to medical economics.
9. Collaborate with the Division of Marketing/Communications in the drafting of TexasMedicine, Texas Medicine Today (e-newsletter), TMA website and other communicationmethods to disseminate medical economics information, resources, and education.
10. Staff TMA Council on Socioeconomics and oversee staff who support all governingphysician bodies reporting to the council, including the Committee on Alternative Payment Models, Committee on Health Information Technology and Augmented Intelligence, Committee on Medicaid, CHIP, and the Uninsured, and Committee on Medical Home and
Primary Care.
11. Staff TMA Reference Committee on Socioeconomics at the annual TEXMED meeting.
12. Staff AMA Reference Committees as assigned.
13. Analyze AMA resolutions for compliance with TMA policy and advise AMA delegation as to whether TMA should support, monitor or oppose.
14. Work with General Counsel staff on regulatory implementation.
15. Assist in the development of and monitoring of the Divisional budget.
16. Supervise the staff of the Division of Medical Economics.
17. Participate in the development and delivery of educational programs by serving as a content expert on billing, coding, reimbursement, regulatory, and payor issues.
18. Perform other related duties as directed or required.

SUPERVISORY RESPONSIBILITY

This position oversees all employees of the division with direct supervision of the three employees who direct and manage the Divisions work on alternative payment models, health information technology and augmented intelligence, Medicaid/CHIP, and medical home & primary care. This role also makes recommendations to senior management including Human Resources and Office of the EVP, regarding position placement.

INDEPENDENCE/SUPERVISION RECEIVED
Assignments are complex and may vary greatly. This requires taking initiative, exercisingindependent judgment, critical thinking, and problem-solving to determine the best and most effective/appropriate courses of action.

Knowledge and Experience:
This position requires a concentrated understanding of medical economics, associated with the attainment of a bachelor's degree in a related field, in addition to 10+ years of related experience. Excellent writing, communication, and leadership skills are essential. Experience managing professional staff preferred.

Preference may be given to individuals with an advanced degree (Masters or PhD) in health economics, health policy, health care management and economics, experienced in health care financing, payor relations, or commercial insurance physician relations. Extensive knowledge of Medicare, Medicaid, and state-regulated and self-funded ERISA plan commercial payment issues, policies and regulations are preferred.

The purpose of a job description is to describe the overall function and general responsibilities of a job. Job descriptions are used in hiring and training and to provide employees with a better understanding of employer expectations. Descriptions are revised as job responsibilities change.

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