Healthcare Specialist

4 weeks ago


Meriden, Connecticut, United States Solventum Full time
Company Overview

Solventum is a leading company 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.

Job Description

We are seeking a skilled Healthcare Specialist to join our team in the Population Management Methodology Groupers department. As a Healthcare Specialist, you will be responsible for providing subject matter expertise in 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.

Key Responsibilities:
  • 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;
  • Document and maintain 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;
  • Maintain process documentation for the methodologies update using C&ER standards and methods;
Required Skills and Qualifications

To be successful in this role, you will need:

  • Bachelor's Degree AND 5+ years' experience in the healthcare industry, ideally medical coding, reimbursement, CDI, and research;
  • 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;
Benefits

We offer a competitive salary and benefits package, including:

  • Medical, Dental & Vision;
  • Health Savings Accounts;
  • Disability Benefits;
  • Life Insurance;
  • Voluntary Benefits;
  • Paid Absences;
  • Retirement Benefits;
Salary

The estimated salary for this position is $80,000-$110,000 per year, depending on experience and qualifications.

We are an equal opportunity employer and welcome applications from diverse candidates. Please note that your application may not be considered if you do not provide your education and work history.



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