Clinical Methodology Analyst – Global Health Solutions

5 days ago


Meriden, Connecticut, United States Solventum Full time

Solventum 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 clinical content development, specification, documentation, validation, application, and maintenance of software modules related to population health Clinical Risk Groups (CRGs), Patient-focused Episodes (PFE) and Potentially Preventable Readmissions (PPRs) measures.

Responsibilities include:

  • Providing subject matter expertise in clinical content development, specification, documentation, validation, application, and maintenance of software modules
  • Contributing to research efforts related to methodologies, providing input into prioritization of potential research enhancements
  • Collaborating with Chief Product Owner, Product Owners, and Research team to drive enhancements to methodologies by translating clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications

Requirements for success in this role include:

  • 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
  • Strong knowledge of patient classification research and development: 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

This position requires:

  • Estimated salary range: $106,331 - $129,960
  • Competitive 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
  • Ability to work in a multicultural, complex, cross-functional, and dynamic work environment, able to prioritize, multi-task, focus on goals, take accountability, and manage time well


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