Full-Time

Clinical development specialist

Posted on 10/31/2024

Solventum

Solventum

Compensation Overview

$137.4k - $168kAnnually

+ Variable Incentive Pay

Mid

No H1B Sponsorship

Remote in USA

Category
Healthcare Administration & Support
Medical, Clinical & Veterinary
Requirements
  • Bachelor’s Degree or higher AND (4) years of (the same job-related experience) OR High School Diploma/GED from AND (8) years of (the same job-related experience)
  • Master's degree in related field, clinical informatics, coding, and/or HIM credentials.
  • Strong knowledge of patient classification research and development: Inpatient and outpatient payment and risk adjustment, Efficiency and quality outcome measures, Commercial, Medicare and Medicaid environments
  • In-depth knowledge of ICD-10-CM, ICD-10-PCS and CPT coding skills
  • Experience with healthcare data, coding, billing, editing and payment, particularly for patient claims and HIPAA requirements.
  • Experience with review and analysis of healthcare regulatory documentation both in the US and international healthcare claim processing and payment policy
  • Ability to evaluate research questions, define analysis, analyze results and statistical output and patterns, document hypotheses and recommendations.
  • Software development experience, bringing products from initial concept to release
  • Ability to effectively communicate ideas, concepts, and information: presenting and training of 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.
  • Passionate, team player that energizes and leads others.
  • High integrity and work ethic are expected and highly valued.
Responsibilities
  • Assuming the primary responsibility of Clinical Analyst in providing subject matter expertise in the clinical content development, specification, documentation, validation, and application of software modules related to International Refined Diagnosis Related Groups (IR-DRGs), including Global growth of APR, EAPG and preventables, as well responsibility of maintaining the specifications of the map and any related mapping for IR-DRG and expansion of outpatient classification variables required for the methodology, holding to standards and best practices.
  • Alignment of EAPG and IR-DRG outpatient, as well as the discipline of inpatient patient classification, procedure classification, inpatient payment, and regulatory update processes, demonstrating the underlying clinical concepts both in the US and international healthcare claim processing and payment policy.
  • Work directly with the Chief Product Owner, Product Owners, Research team and government agencies to drive enhancements to the methodologies by reviewing proposed suggested changes, defining evaluation approach and specifications, review of results and proposal of recommendations towards updates to clinical logic that include clear clinical logic specifications using existing coding system definitions.
  • Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and test the clinical specification.
  • Responsible for maintaining process documentation for the IR-DRGs update using C&ER standards and methods.

Company Stage

N/A

Total Funding

N/A

Headquarters

N/A

Founded

N/A

INACTIVE