ACR Insurance Subcommittee

Opportunity Overview

The ACR Insurance Subcommittee has the following open positions. All positions are virtual.

• ACR Member-at-Large (4)

Eligibility

Please review the volunteer eligibility guidelines based on your member type and industry involvement before submitting a volunteer application.
Volunteer Eligibility Guidelines >

Subcommittee Description

The ACR Insurance Subcommittee is a subcommittee of the Committee on Rheumatologic Care (CORC). It monitors and addresses insurance-related policies that affect rheumatology practices and patient access to care. The work of the subcommittee directly supports the ACR's efforts to improve access to high-quality rheumatology care and reduce administrative burdens associated with insurance coverage and payment policies.

Responsibilities

The volunteers serves as a subject matter expert group for payer and coverage issues, providing guidance and recommendations to ACR staff and leadership on insurance trends, reimbursement challenges, prior authorization requirements, and coverage policies impacting rheumatology services and treatments. In the coming year, the subcommittee will support projects related to payer policy analysis, prior authorization reform efforts, coverage and reimbursement issues for medications and services, development of member resources and educational materials, and responses to emerging insurance and utilization management challenges.

Subcommittee members may be asked to review payer policies, provide clinical expertise on coverage determinations, contribute to advocacy priorities, and assist with the development of tools and communications for rheumatology professionals.

The ACR staff is responsible for the administration and project management of all initiatives and programs.

Time Commitments

Virtual

• Meetings: Typically 1 hour per month in the evening

Asynchronous Work
About 2–3 hours per quarter for:

• Email review and project-based work between meetings as needed
• Periodic requests to review documents, provide feedback on payer-related issues, and participate in discussions regarding emerging insurance challenges affecting rheumatology practices and patients

Recommended Qualifications

The subcommittee welcomes all volunteers from a variety of practice settings, career stages, and areas of expertise, representing diverse professional experiences, backgrounds, and perspectives to help identify insurance barriers and develop solutions that improve patient access to high-quality rheumatologic care. The committee mix would benefit from adding:

• Private practice and academic rheumatologists to ensure insurance and reimbursement challenges are evaluated across diverse care settings
• Early-career, mid-career, and seasoned rheumatology professionals to provide a broad range of experiences and viewpoints
• Members with expertise in practice operations, billing, coding, reimbursement, and revenue cycle management, particularly those with firsthand experience navigating payer requirements
• Rheumatology professionals with experience addressing prior authorization, utilization management, step therapy, and medication access barriers
  • Adult and pediatric rheumatology perspectives to ensure insurance-related issues affecting all patient populations are considered
• Advanced practice providers (NPs and PAs) and other care team members who regularly interact with insurance processes and patient access challenges
• Members from geographically diverse regions and a variety of practice sizes to capture differences in payer policies and market dynamics across the country
• Individuals interested in advocacy and health policy, especially those willing to provide subject matter expertise on emerging payer and coverage issues affecting rheumatology care

Interested participants for this subcommittee should have knowledge or experience in one or more of the following areas:

• Commitment to advancing equitable access to high-quality rheumatology care, reducing administrative burdens for patients and providers, and addressing payer-related challenges
• Health policy, advocacy, and reimbursement issues affecting rheumatology
• Working with or navigating insurance coverage policies, prior authorization, step therapy, utilization management, and medication access programs
• Knowledge of practice operations, billing, coding, and reimbursement processes
• Experience identifying and addressing patient access barriers related to insurance coverage and payment policies
• Reviewing, analyzing, and providing feedback on payer policies, regulatory proposals, and coverage determinations
• Strong critical thinking and problem-solving skills, particularly related to complex payer and access issues
• Experience collaborating with multidisciplinary teams and contributing to consensus-based recommendations
• Willingness to share frontline perspectives on challenges affecting rheumatology practices and patients
• Developing educational resources, guidance documents, and advocacy priorities for ACR members
• Prior volunteer experience is helpful but not required
• Individuals with a strong interest in insurance, reimbursement, patient access, and advocacy issues are encouraged to apply