Healthcare Consultant, Population Health & Payment Strategy - Albany, NY/Remote

SOLVENTUM•Albany, NY

21h•$125,600 - $172,700•Remote

About The Position

Solventum Health Information Systems (HIS) is a leader in helping commercial and government payers control costs and increase access to quality care with clinically based methodologies developed and refined over more than 40 years. These reliable metrics support efforts to analyze and track performance, reduce inefficiencies, and drive better outcomes. The person hired for the position of Healthcare Consultant, Population Health & Payment Strategy will join a strong team focused on driving provider, payer and business partner opportunities for those Solventum measures used for payment, quality, and performance management by government, commercial, and international payer programs. Payment innovation, value-based care, patient safety solutions center our efforts.

Requirements

Bachelor’s Degree or higher from an accredited university AND 8 years of experience in the healthcare field OR High School Diploma/GED or higher from an accredited institution and a minimum of 12 years of experience in the healthcare field in lieu of the bachelor’s degree education requirement
Eight (8) years of experience in one or more of the following areas: healthcare consulting, healthcare payment, healthcare administration, health plans, and/or data analysis
3 years of experience working with claims and/or clinical data
Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Nice To Haves

Master's degree in healthcare field or business administration.
Experience with one or more of the HIS proprietary patient classification tools such as Solventum™ CRG, Solventum™ PPEs, Solventum™ APR DRG, and Solventum™ EAPG and risk adjustment concepts
Experience with commercial, Medicaid and Medicare health plan operations.
Experience with payment consulting, payment operations, and/or provider contract negotiations.
Experience with quality reporting, quality program design, and gaps identification payment integrity, risk adjustment management, value-based purchasing, and/or accountable care organizations.
Experience developing value-based strategies focusing on improving cost and quality outcomes.
Experience merging clinical and claims data
Experience with healthcare claims data and developing technical specifications

Responsibilities

Leverage deep understanding of healthcare industry trends and Solventum methodologies to address complex client challenges and deliver innovative solutions that improve outcomes and reduce costs.
Establish and maintain strong relationships with clients and internal stakeholders by anticipating needs, providing expert guidance, and collaborating across departments to create effective solutions.
Directly impact the development and implementation of innovative payment initiatives with client partners.
Develop and communicate strategies, policies, and business requirements; translate them into technical specifications; and oversee data analysis, reporting, and presentation development for internal and external audiences.
Manage multiple projects of varying scope concurrently, lead client meetings, resolve issues promptly, and update clients and senior leaders on progress and results.
Use expertise in healthcare claims to thoroughly examine client data, pinpointing trends and anomalies to provide recommendations and develop effective remediation strategies.
Provide expert-level consulting, training, and support on Solventum classification products to clients and internal teams, supporting new product releases, tools, market expansion efforts, educational programs, and training sessions.
Drive discussions on market trends, lead innovative consulting initiatives, and act as a subject matter expert on industry topics and Solventum products both internally and externally.
Comply with corporate policies, procedures and security standards while performing assigned duties.