Clinical Methodology Specialist for Healthcare Payment Systems
3 days ago
We are a leading provider of innovative solutions for the healthcare industry, with a strong legacy of delivering breakthrough products that address our customers' most pressing challenges. Our team pioneers game-changing innovations at the intersection of health, data science, and materials, driving positive change in patients' lives while empowering healthcare professionals to perform at their best.
About Solventum HISSolventum 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.
Job Description:The primary responsibility of this role is 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, budgeting, tracking, and setting policy for value-based payment and care.
Responsibilities:- Work directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating clinical hypotheses into clinical logic content specifications using existing coding systems;
- Document and maintain clear clinical specifications;
- Collaborate with technical, quality, and clinical team members to integrate product concepts and implement and evaluate clinical specifications;
- Maintain process documentation for methodology updates using C&ER standards and methods;
- Bachelor's Degree AND 5+ years' experience in the healthcare industry, ideally medical coding, reimbursement, CDI, and research; OR High School Diploma AND 9+ years' 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;
- Working with clinical-coding and patient classification/quality outcome measures;
- Experience working with excel and databases;
- Master's degree in related field, clinical informatics, clinical coding, and/or HIM credentials;
- Outpatient payment and risk adjustment;
- Commercial, Medicare and Medicaid environments;
- In-depth knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, and NDC coding skills;
- Experience with healthcare data, coding, billing, editing and payment, particularly for inpatient claims and HIPPA requirements;
- 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;
This position offers a competitive salary range of $120,000 - $150,000 per year, depending on qualifications and experience. Additionally, Solventum provides a comprehensive benefits package, including Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences, and Retirement Benefits.
-
Healthcare Specialist
1 week ago
Meriden, Connecticut, United States Solventum Full timeCompany OverviewSolventum 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 DescriptionWe are seeking a skilled Healthcare Specialist to join our team in the Population...
-
Meriden, Connecticut, United States Solventum Full timeSolventum is a global leader in designing and maintaining healthcare payment systems. We support more than ten countries on how they budget and pay for inpatient and outpatient care, and measure healthcare quality.The Impact You'll MakeAs a Clinical Analyst, you will provide subject matter expertise in clinical content development, specification,...
-
Meriden, Connecticut, United States Solventum Full timeSolventum is a global leader in designing and maintaining healthcare payment systems and creating value in the healthcare industry. We partner with top healthcare professionals to pioneer innovative solutions that improve lives and enable better, smarter, safer healthcare.The primary responsibility of this role is to provide subject matter expertise in...
-
Meriden, Connecticut, United States Solventum Full timeJob Title: Healthcare Data Analyst with Clinical Coding ExpertiseSolventum is a leading healthcare payment system designer and maintainer, supporting over ten countries in budgeting and paying for inpatient and outpatient care. We pioneer innovations at the intersection of health, material, and data science.About SolventumWe support more than ten countries...
-
Clinical Expert in Population Health Management
3 weeks ago
Meriden, Connecticut, United States Solventum Full timeOverviewSolventum is a leading innovator in healthcare payment systems and value-based care. As a clinical analyst, you will play a crucial role in developing and maintaining software modules for population health management methodologies.
-
Meriden, Connecticut, United States Solventum Full timeSolventum is a leading provider of healthcare payment systems and solutions. As a Senior Clinical Data Analyst, you will play a crucial role in designing and maintaining our software modules related to population health clinical risk groups, patient-focused episodes, and potentially preventable readmissions.Company OverviewAt Solventum, we enable better,...
-
Clinical Oncology Specialist
3 weeks ago
Meriden, Connecticut, United States Hartford Healthcare (HHC) Full timeDescription Hartford HealthCare, the largest integrated healthcare system in Connecticut, offers a rewarding opportunity for an experienced Clinical Oncology Specialist to join our team and provide value-based care to patients primarily in outpatient settings. About this Role This position involves providing comprehensive patient care in oncology settings,...
-
Healthcare Informatics Consultant
3 days ago
Meriden, Connecticut, United States Solventum Full timeAbout the Role:We are Solventum, a pioneering company that creates innovative solutions for the healthcare industry.This position involves collaborating with product owners and research teams to drive enhancements to methodologies by translating clinical hypotheses into specifications.Key responsibilities include providing subject matter expertise,...
-
Travel Healthcare Specialist
7 hours ago
Meriden, Connecticut, United States Host Healthcare Full timeHost Healthcare is seeking a dedicated Travel Healthcare Specialist to join their team in Connecticut. This exciting opportunity allows you to explore your travel nursing career while providing exceptional care in the Emergency Department.About the RoleThis 13-week assignment offers a unique chance to work with a leading healthcare provider and gain valuable...
-
Meriden, Connecticut, United States solventum Full timeResponsibilitiesContributing and coordinating research efforts related to methodologies, providing input into prioritization of potential research enhancements;Working directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating clinical hypotheses into clinical logic content...
-
Clinical Laboratory Specialist
1 week ago
Meriden, Connecticut, United States KA Recruiting Inc. Full timeWe are seeking a highly skilled Clinical Laboratory Specialist to join our team at KA Recruiting Inc.With a focus on quality and excellence, this role is perfect for individuals who are passionate about laboratory work and have a strong desire to grow their career.The successful candidate will be responsible for working in a dynamic laboratory environment,...
-
Commissioning Systems Specialist
3 weeks ago
Meriden, Connecticut, United States Bestlogic Staffing Full timeJob DescriptionWe are seeking a highly skilled Commissioning Systems Specialist to support the commissioning of mechanical and electrical systems, including HVAC, plumbing, fire protection, power, lighting, and building envelope systems.This role ensures that all systems are installed, tested, and operational before being handed over to clients.The ideal...
-
Systems Installation Specialist
3 days ago
Meriden, Connecticut, United States Bestlogic Staffing Full timeAt BestLogic Staffing, we are seeking a skilled Systems Installation Specialist to support the commissioning of mechanical and electrical systems.Job SummaryWe offer a competitive salary range of $85,000 - $110,000 per annum, depending on experience.The ideal candidate will have experience in controls, testing and balancing, or MEP...
-
Electrical Systems Specialist
3 weeks ago
Meriden, Connecticut, United States Solventum Full timeExciting Career Opportunity at SolventumWe are seeking a skilled Electrical Systems Specialist to join our team in Meriden, CT. As a key member of our maintenance team, you will play a critical role in ensuring the smooth operation of our facilities.About the JobThe successful candidate will be responsible for troubleshooting, repairing, and maintaining...
-
Clinical Risk Groups Analyst Position
1 day ago
Meriden, Connecticut, United States Solventum Full time**Job Description**We are seeking an experienced Clinical Analyst to join our team. As a Clinical Analyst, you will provide subject matter expertise in clinical content development, specification, documentation, validation, application, and maintenance of software modules related to Solventum's population health methodologies.
-
Clinical Travel Nurse
3 weeks ago
Meriden, Connecticut, United States TotalMed Staffing Full timeJob Title: Clinical Travel Nurse - Telemetry SpecialistAbout the Role:TotalMed Staffing is seeking a skilled clinical travel nurse for a telemetry position in Meriden, Connecticut. As a registered nurse with expertise in telemtry care, you will have the opportunity to work with patients who require close monitoring and support.Responsibilities:Provide...
-
Meriden, Connecticut, United States Solventum Full timeAbout SolventumSolventum is a pioneering company at the intersection of health, material, and data science. We create breakthrough solutions for our customers' toughest challenges, changing patients' lives for the better while enabling healthcare professionals to perform at their best.SalaryThe estimated salary for this position in Meriden, CT ranges from...
-
Travel Nurse ER Specialist
3 weeks ago
Meriden, Connecticut, United States MedPro Healthcare Staffing Full timeAbout the RoleWe are seeking a skilled Travel Nurse ER Specialist to join our team at MedPro Healthcare Staffing.This is a 13-week travel nursing job in Meriden, Connecticut.Job SummaryThe successful candidate will have experience working in an Acute Care Emergency Room setting and be able to provide high-quality patient care.Key responsibilities include...
-
Meriden, Connecticut, United States Solventum Full time**Company Overview**Solventum is a global leader in designing and maintaining healthcare payment systems. We support more than ten countries in budgeting and paying for inpatient and outpatient care, as well as measuring healthcare quality.
-
Healthcare Manager
3 days ago
Meriden, Connecticut, United States Elevance Health Full timeElevance Health seeks a skilled Care Coordination Specialist to join our team. As a key member of our care management team, you will play a critical role in ensuring the optimal health outcomes for our members.The estimated salary for this position is $83,174 - $142,928. In addition to your salary, Elevance Health offers a comprehensive benefits package,...
