Job Description
Roles and Responsibilities
Primary skills : Payers, Pharmacy benefit Management
Notice Period: 60 days maximum.
Skills required:
- Work on Healthcare Space comprising Payers (Medicare Commercial plans), Pharmacy Benefit management, Healthcare Provider ACO organization's etc.
- Perform activities which is part of bigger solution using ICD9, ICD10, CPT, HCPCS classification system
- Provide insights to the core analytical team on the medical markers and work with them on the advanced analytical project
- Perform analytical activities using Microsoft Excel, SQL, and BASIC SAS and can use or pick up any analytical tool that is organization specific.
- To create analytical products on claims data coming from Payers (medical & Rx), CMS, Blue Health plans, PBMs etc. and understand how they are aligned to each other & there significance also to create insights and perform analysis like comparative rate between healthcare products, reimbursement & cost analysis, financial impact calculations, and national or regional market analysis related to healthcare products and similar analysis on this area of work
- Translate business requirements, develop business cases, and recommend solutions. Be client focused, Drive best practices through business processes knowledge
- Perform research to identify business problems and ability to breakdown complex business issues to come up with solutions through extensive data analysis
- Experience working in Agile projects is preferred. .
Candidate Profile
- Demonstrated work experience in healthcare life sciences data analytics programs for minimum of 5 years. Experience on Medical coding related to ICD9, ICD10, CPT, HCPCS classification system
- Possess significant experience in clinical and or healthcare claims data, healthcare reforms programs and claims (medical & Rx) data coming from Payers, CMS, Health plans, PBMs
- Prior experience in population health, quality measures, evidence based alerts, various incentive programs including ACO, Meaningful Use, PQRS,PCMH, CPCI and PPIC
- Prior experience in analyzing healthcare claims data, developing comparative rate and reimbursement analysis, cost analysis and financial impact calculations, and national or regional market studies.
- Strong analytical skills with the ability to collect, organize, analyze data using Microsoft Excel, SQL, and BASIC SAS and can use or pick up any analytical tool which is organization specific.
- Working knowledge of health care analytics in a Payers, Pharmacy Benefit management, and Healthcare Provider ACO organization.
Job Requirements: SQL, Business User Analysis, Requirements Analysis, Agile, ETL Validation, Business Requirment Document
Mandatory Skills
SQL,
If interested please share your profile on ne*********3@mi*****e.com
Job Classification
Industry: IT Services & Consulting
Functional Area: IT Software - Other,
Role Category: System Design/Implementation/ERP/CRM
Role: System Design/Implementation/ERP/CRM
Employement Type: Full time
Education
Under Graduation: Any Graduate
Post Graduation: Medical-MS/MD in Gyneocology
Doctorate: Doctorate Not Required
Contact Details:
Company: Mindtree
Address: GLOBAL VILLAGE,,,MYSORE,RVCE POST, BANGALORE, Karnataka, India
Location(s): Hyderabad
Keyskills:
Payer
US Healthcare
Business Analysis
Claim enrollment
Billing