Full-Time

Solventum HIS Clinical Analyst

Population Management Methodology Groupers

Confirmed live in the last 24 hours

Solventum

Solventum

Compensation Overview

$106.3k - $130kAnnually

+ Variable Incentive Pay

Senior, Expert

No H1B Sponsorship

Remote in USA

Must be legally authorized to work in country of employment without sponsorship for employment visa status.

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Required Skills
Data Analysis

You match the following Solventum's candidate preferences

Employers are more likely to interview you if you match these preferences:

Degree
Experience
Requirements
  • Bachelor’s Degree AND 5+ years’ experience in the healthcare industry, ideally medical coding, reimbursement, CDI, and research
  • OR High School Diploma AND 9+ experience in the healthcare industry, ideally medical coding, reimbursement, CDI, and research.
  • HIM credentials or Clinical Informatics background as it relates to claims data research, analysis, disease processes and treatment, medical terminology, anatomy, and physiology.
Responsibilities
  • Providing subject matter expertise in the clinical content development, specification, documentation, validation, application, and maintenance of software modules related to Solventum population health Clinical Risk Groups (CRGs), Patient-focused Episodes (PFE) and Potentially Preventable Readmissions (PPRs) measures.
  • Contributing and coordinating with the research efforts related to the methodologies, provide input into the prioritization of the potential research enhancements.
  • Work directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating the clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications.
  • Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and evaluate the clinical specification.
  • Responsible for maintaining process documentation for the methodologies update using C&ER standards and methods.
Desired Qualifications
  • Working with clinical-coding and patient classification/quality outcome measures
  • Ability to collaborate with a diverse professional team, including researchers, healthcare providers, and engineers.
  • Experience working with excel and databases
  • Master's degree in related field, clinical informatics, clinical coding, and/or HIM credentials.
  • Strong knowledge of patient classification research and development: Outpatient payment and risk adjustment, Commercial, Medicare and Medicaid environments
  • In-depth knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and NDC coding skills
  • Experience with healthcare data, coding, billing, editing and payment, particularly for inpatient claims and HIPPA requirements.
  • Experience with review and analysis of federal and state regulatory documentation related to healthcare claim processing and payment as well as understanding of the CMS rule making process for outpatient payment.
  • Ability to evaluate research questions, analyze results and statistical output and patterns, and document hypotheses and recommendations.
  • Software development experience, bringing products from initial concept to release.
  • An ability to effectively communicate ideas, concepts, and information: presenting and training clinical concepts, coding systems and underlying design of patient classification methodologies in healthcare.
  • Comfortable in a multicultural, complex, cross-functional, and dynamic work environment, able to prioritize, multi-task, focus on goals, take accountability, and manage time well.
  • Ability to take individual initiative and responsibility for assignments while working independently and in a team environment.
  • Enthusiastic, collaborator that energizes and leads others.
  • High integrity and work ethic are expected and highly valued.

Company Stage

N/A

Total Funding

N/A

Headquarters

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Founded

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