Healthcare Consultant Jobs

About The Position

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.

Benefits

• Medical, Dental & Vision
• Health Savings Accounts
• Health Care & Dependent Care Flexible Spending Accounts
• Disability Benefits
• Life Insurance
• Voluntary Benefits
• Paid Absences
• Retirement Benefits