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Tech Stack
Tools & technologiesETLMS SQL ServerSQL
About the role
Key responsibilities & impact- 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
What you’ll need- 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
Comp & perks- Medical, Dental & Vision
- Health Savings Accounts
- Health Care & Dependent Care Flexible Spending Accounts
- Disability Benefits
- Life Insurance
- Voluntary Benefits
- Paid Absences
- Retirement Benefits
ATS Keywords
✓ Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
data analysisbusiness requirements gatheringSQL queriesdata warehousingbusiness intelligenceclaim analyticsbillingmember eligibilityprovider dataclinical data management
Soft Skills
collaborationcommunicationresults orientationownershipsense of urgencygrowth mindset