37 applicants
NAM Info Inc · 2 days ago
Business System Analyst with Fee Schedule Experience
United States
Contract
Remote
Senior Level
5+ years exp
Wonder how qualified you are to the job?
Maximize your interview chancesCommunitiesInformation and Communications Technology (ICT)
Hiring Manager
Jawaharlal Nehru G
Insider Connection @NAM Info Inc
Responsibilities
Prepare analyses for contract renewals, including trend analysis (volume, spend, unit cost, case mix, LOS); cost analyses; benchmark analyses. Assist in proposal development for contract negotiations.
Analyze population health and performance improvement metrics, analyze payer claims data to monitor quality performance such as HEDIS metrics.
Use external benchmark sources (i.e., Medicare fee schedules, Milliman data, HEDIS, etc.) and facile in extracting publicly available data.
Develop Business Requirement Documentation (BRD’s) and Functional Requirement Documentation (FRD’s)
Identify, define, procure, synthesize, and manage data from various sources and systems, including but not limited to internal hospital finance, professional finance, and external data such as payer claims and eligibility data.
Document and map data in a variety of formats, cross-referencing key data elements and normalizing data across sources as required to provide accurate and meaningful data sets, for further analysis and use.
Work closely with clinical areas to understand and model financial impact of emerging clinical services and changes in delivery/site of care. Take the lead on modeling bundled payments for specific payers.
Perform other related duties as required.
Qualification
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Required
Bachelor's degree required; master’s degree in computer science/information technology a plus.
5+ years’ experience at a health plan, hospital or in a similar healthcare analytical role.
Strong communications skills and attention to detail.
Experience in presentation and/or training.
Good interpersonal skills.
Knowledge of Medical Terminology and Coding preferred.
Experience in a multi-stakeholder healthcare setting a plus; ability to thrive in a fast-paced, highly collaborative environment.
Document business requirements for end-to-end data migration projects, system implementations, and system support management.
Oversee detailed complex provider records management and data export and ingest between multiple stakeholders.
Collaborate on projects related to Provider Data Modernization, Provider enrollment standardization, system integrations, and provider credentialing.
Contribute to requirement gathering, documentation, business case creation, and scenario documentation. Balance multiple priorities while meeting commitments for quality and delivery within agreed-upon schedules. Communicate effectively orally and in writing, internally and with clients.
Preferred
Knowledge of Medical Terminology and Coding preferred.
Experience in a multi-stakeholder healthcare setting a plus; ability to thrive in a fast-paced, highly collaborative environment.
Company
NAM Info Inc
NAM Info Inc.
51-200 employees
H1B Sponsorship
NAM Info Inc has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Trends of Total Sponsorships
2023 (18)
2022 (45)
2021 (35)
2020 (27)
Funding
Current Stage
Growth StageLeadership Team
Shyam Valloornatt
Chief Operating Officer
Company data provided by crunchbase
