Job Description: • Joining a collaborative cross functional team with representatives across the organization to enhance and support payer products and services • Working with subject matter experts, defining business requirements, standard business rules, and producing documentation that is client-facing as well as technical documentation used by developers • Performing data analysis and reviewing business rules with business stakeholders to refine product requirements • Validating results from development teams for implementation of business rules and business requirements • Presenting standard product capabilities to support product implementation and post implementation lifecycles Requirements: • Bachelor’s Degree or higher from an accredited university AND eight (8) experience in Healthcare Information Technology. • OR High School Diploma/GED AND a minimum of twelve (12) years of experience in Healthcare Information Technology. • Six (6) years of experience working in the Healthcare industry, preferably with data analytic experience of commercial, Medicaid and/or Medicare health plans. • Strong knowledge in claim analytics, billing, member eligibility, provider data, and quality reports. • Six (6) years of experience performing requirements gathering and analysis. • Six (6) years of experience in writing SQL queries for large data warehouses. • Five (5) years in an analyst role documenting business rules and source to target mapping. • Additional qualifications that could help you succeed even further in this role include: Experience with provider-level data, clinical data management, and working within Microsoft SQL Server environments. • Familiarity with data warehousing and business intelligence terminology, along with experience collaborating with ETL developers, BI architects, and report developers to communicate data mapping. • Experience working within an agile development organization. • Understanding of MS-DRG and APC, as well as proprietary Solventum methodologies, including APR DRG, EAPG, CRG, PPR, PPC, AM-PPC, PFP, and PFE. • Familiarity with statistical methods and models to provide analytic and methodology guidance, along with demonstrating a sense of urgency, ownership, results orientation, and a growth mindset supporting healthcare payment innovation, patient safety, efficiency, quality of care, and value-based care efforts. Benefits: • Medical, Dental & Vision • Health Savings Accounts • Health Care & Dependent Care Flexible Spending Accounts • Disability Benefits • Life Insurance • Voluntary Benefits • Paid Absences • Retirement Benefits Apply tot his job Apply To this Job
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