Domain Expert

1 week ago

Hyderabad, India Tredence Inc. Full time

We are seeking a highly skilled and experienced SME in US Healthcare Payer and Provider Data and Analytics space. You will work closely on Payer and Provider solutions to design, implement, and optimize value-based care analytics, Population health, utilization management, member engagement, clinical and claims analytics leveraging data management, analytics, AI/ML, and GenAI to improve outcomes, reduce costs, and enhance patient experiences.

Key Responsibilities:

Value-Based Care Strategy & Implementation

  • Champion data and analytics solution offerings across value-based care, care management, member engagement, clinical and claims analytics.
  • Advise payers and providers on operational analytics, population health, utilization management, and care coordination to enable VBC success.

Data-Driven Insights & Performance Optimization

  • Collaborate with data engineering and analytics teams to design dashboards and AI-driven predictive models for patient stratification, readmission prevention, and cost optimization.
  • Shape next-gen solutions leveraging Agentic AI for clinical decision support, prior authorization, claims adjudication, and RCM workflows.
  • Provide strategic guidance on integrating EHR, claims, and SDoH data to deliver measurable improvements in quality and cost outcomes.

Stakeholder Engagement & Advisory

  • Drive requirement discussions, solution strategy, scope and approach to evangelize the solutions development with technical team.
  • Support sales and business development teams by providing subject matter expertise in client discussions, RFP responses, and solution demonstrations.

Regulatory Compliance & Market Trends

  • Stay updated on healthcare policies, CMS regulations, and emerging VBC trends to ensure clients remain compliant and competitive.
  • Conduct industry research and contribute to whitepapers, webinars, and client education sessions on value-based care strategies.

Required Skills and Experience:

Domain Expertise

  • Deep understanding of value-based care models, population health management, and risk-based

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