Population Health BA
16 hours ago
: Population Health BA Analytical Services
Locations:
- Hinjewadi, Pune, India
- Coimbatore, Tamil Nadu
- Chennai, India
- Must demonstrate strong domain expertise, particularly in the Payor-Provider ecosystem, with a solid understanding of Medicare, Medicaid, and other relevant healthcare programs.
- Works with stakeholders to discover, clarify, and document current and future data needs.
- Performs mapping of Population Health and Care Management data to a normalized data model.
- Serves as a subject matter expert on the Population health data domains such as Care Management, Utilization Management, Quality Scores, HEDIS, Care gaps.
- Builds data concepts to support Population Health use cases.
- Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.
- Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards.
- Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues.
- Works with customers to clarify and plan for their current and future technology needs. Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system.
- Designs and implements projects requiring systems integration, small teams and multiple technical platforms.
- Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
- Collaborates on driving improvement activities to achieve department and organizational goals.
- Coordinates with functional team to assure consistency and optimization of overall work product.
- Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
- Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes.
- Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation.
- Identifies opportunities for process improvement and makes recommendations that lead to improvements.
- Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality.
- Escalates process and project issues that cannot be resolved.
- Prior experience working as a Population Health analyst in the Healthcare system.
- Must have a working knowledge of relational databases/database structures; SQL expertise desired.
- Must have a strong understanding of data collected and used in Claims, Adjudications, Health Insurance, and Care and Utilization Management.
- Knowledge and experience with ambulatory and acute clinical, billing and claims workflows and clinical information systems.
- Bachelor or Master's degree in related health or finance field (e.g., informatics or bioinformatics).
- Complexity of work: Within the scope of job, requires critical thinking skills, decisive judgment, and the ability to work with minimal supervision. Must be able to work in a stressful environment.
- 5 years of experience preferred.
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