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.
Tech Stack
ETL
MS SQL Server
SQL
Benefits
Medical, Dental & Vision
Health Savings Accounts
Health Care & Dependent Care Flexible Spending Accounts