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Company

Genzeon · 2 hours ago

Healthcare Payer Automation Consultant

United States

Part-time

Remote

Senior Level, Lead/Staff

10+ years exp

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Information TechnologyRobotics

Growth Opportunities

Hiring Manager

Anil Kumar Padhy

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Responsibilities

Strategic assessment of clients' current payer operations and automation maturity

Development of automation strategy and roadmap tailored to client needs

Advisory services for HEDIS reporting optimization and STAR ratings improvement

Process reengineering recommendations for Prior Authorization workflows

ROI analysis and business case development for automation initiatives

Best practices guidance for healthcare quality metrics and reporting

Change management and stakeholder alignment support

Automation opportunity assessments and gap analysis reports

Strategic roadmaps and implementation plans

ROI and business case documentation

Process optimization recommendations

Technology solution evaluations

Best practices documentation and training materials

Performance benchmark reports and industry insights

Change management and communication plans

Qualification

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Healthcare AdministrationHealthcare Payer OperationsHEDIS MeasuresSTAR RatingsPrior Authorization ProcessesConsulting ExperienceAutomation Strategy DevelopmentROI AnalysisHealthcare ComplianceRPA PlatformsSix Sigma CertificationPMP CertificationHealthcare AnalyticsChange ManagementStrategic PlanningClient Relationship ManagementWorkshop Facilitation

Required

Bachelor's degree in Healthcare Administration, Information Technology, or related field.

10+ years of experience in healthcare payer operations.

10+ years of consulting experience in healthcare process automation.

Deep understanding of HEDIS measures, STAR ratings, and quality improvement programs.

Deep understanding of Prior Authorization processes (both clinical and non-Clinical processes).

Proven track record of successful automation advisory projects.

Strong knowledge of healthcare industry metrics and benchmarks.

Experience in strategic planning and roadmap development.

Preferred

Master's degree in Healthcare Administration or related field.

HEDIS Compliance Certification.

Healthcare-specific consulting experience with top-tier consulting firms.

Experience with major RPA platforms and automation technologies.

Knowledge of healthcare regulatory requirements and compliance.

Six Sigma or PMP certification.

Company

Genzeon

Genzeon advances highly effective, secure, and innovative technology solutions for healthcare and retail clients, including intelligent automation, security, compliance, and cloud services.

Founded in 2010

Exton, Pennsylvania, USA

501-1,000 employees