Population Health BA

16 hours ago

Coimbatore, Tamil Nadu, India Saama Technologies Pvt Ltd Full time ₹ 12,00,000 - ₹ 24,00,000 per year
Job Description

Population Health BA Analytical Services

Locations:
Hinjewadi, Pune, India
Coimbatore, Tamil Nadu
Chennai, India

Description Consultant Technical Analyst - Population Health and Care Management

Job Summary:

  • 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.

Responsibilities:

  • 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.

Experience:

  • 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 Masters 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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