Solventum HIS Clinical Analyst – Population Management Methodology Groupers

Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a new company named Solventum. We are still in the process of updating our Careers Page and applicant documents, which currently have 3M branding. Please bear with us. In the interim, our Privacy Policy here: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ continues to apply to any personal information you submit, and the 3M-branded positions listed on our Careers Page are for Solventum positions. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.Job Description:Job Title: Solventum HIS Clinical Analyst – Population Management Methodology Groupers3M Health Care is now SolventumAt Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.The Impact You’ll Make in this Role Solventum HIS is an international leader in designing and maintaining healthcare payment systems and creating healthcare value. We support more than ten countries on how they budget and pay for inpatient and outpatient care, and measure healthcare quality.  Here, you will make an impact by:The primary responsibility of Clinical Analyst is providing subject matter expertise in the clinical content development, specification, documentation, validation, application, and maintenance of software modules related to Solventum population health Clinical Risk Groups (CRGs), Patient-focused Episodes (PFE) and Potentially Preventable Readmissions (PPRs) measures. These methodologies have a basis in diagnostic, procedural, and medication codes, and are used throughout the world to care management, population risk adjustment, bundled payment, budget, track, and set policy for value-based payment and care.Contributing and coordinating with the research efforts related to the methodologies, provide input into the prioritization of the potential research enhancements. Work directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating the clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications. Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and evaluate the clinical specification. Responsible for maintaining process documentation for the methodologies update using C&ER standards and methods.Your Skills and Expertise  To set you up for success in this role from day one, Solventum is looking for candidates who must have the following qualifications:Bachelor’s Degree AND 5+ years’ experience in the healthcare industry, ideally medical coding, reimbursement, CDI, and research OR High School Diploma AND 9+ experience in the healthcare industry, ideally medical coding, reimbursement, CDI, and research.HIM credentials or Clinical Informatics background as it relates to claims data research, analysis, disease processes and treatment, medical terminology, anatomy, and physiology.Additional qualifications that could help you succeed even further in this role include:Working with clinical-coding and patient classification/quality outcome measures, and Ability to collaborate with a diverse professional team, including researchers, healthcare providers, and engineers.Experience working with excel and databasesMaster's degree in related field, clinical informatics, clinical coding, and/or HIM credentials. Strong knowledge of patient classification research and development: Outpatient payment and risk adjustmentCommercial, Medicare and Medicaid environmentsIn-depth knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and NDC coding skillsExperience with healthcare data, coding, billing, editing and payment, particularly for inpatient claims and HIPPA requirements.Experience with review and analysis of federal and state regulatory documentation related to healthcare claim processing and payment as well as understanding of the CMS rule making process for outpatient payment.Ability to evaluate research questions, analyze results and statistical output and patterns, and document hypotheses and recommendations.Software development experience, bringing products from initial concept to release.An ability to effectively communicate ideas, concepts, and information: presenting and training clinical concepts, coding systems and underlying design of patient classification methodologies in healthcare.Comfortable in a multicultural, complex, cross-functional, and dynamic work environment, able to prioritize, multi-task, focus on goals, take accountability, and manage time well.Ability to take individual initiative and responsibility for assignments while working independently and in a team environment.Enthusiastic, collaborator that energizes and leads others.High integrity and work ethic are expected and highly valued.Work location: RemoteMust be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).Supporting Your Well-being Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other companies that are comparable in size and scope. Applicable to US Applicants Only:The expected compensation range for this position is $106,331 - $129,960, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-RewardsResponsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process.  Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.Solventum is an equal opportunity employer.  Solventum  will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.Solventum Global Terms of Use and Privacy StatementCarefully read these Terms of Use before using this website. Your access to and use of this website and application for a job at Solventum are conditioned on your acceptance and compliance with these terms.Please access the linked document by clicking here, select the country where you are applying for employment, and review. 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