Concept Development Analyst

ABOUT PERFORMANT:

At Performant, we're focused on helping our clients achieve their goals by providing technology-enabled services which identify improper payments and recoup or prevent losses due to errant billing practices. We are the premier independent healthcare payment integrity company in the US and a leader across several markets, including Medicare, Medicaid, and Commercial Healthcare. Through this important work we accomplish our mission: To offer innovative payment accuracy solutions that allow our clients to focus on what matter most – quality of care and healthier lives for all.

If you are seeking an employer who values People, Innovation, Integrity, Fun, and fostering an Ownership Culture – then Performant is the place for you

ABOUT THE OPPORTUNITY:

Hiring Range: $69,300 - $85,000

The Concept Development Analyst is responsible for providing Subject Matter Experts with operational and analytical support in the payment integrity space, across all lines of business. Manage, provide, and support strategic planning, decision-making, monitoring, through data analysis, issue performance. Independent worker with team-minded work ethics that has knowledge of Centers for Medicare & Medicaid Services (CMS) and Commercial billing guidelines and contracts, applicable laws and policies, changes in technology, practice and regulatory issues.

Key Responsibilities

• Responsible for a variety of tasks, including, but not limited to, providing support to the team, preparing agendas, scheduling meetings, maintaining meeting notes, drafting communications, preparing reports, tracking deliverables, special projects and other tasks as assigned.
• Partnering with the SME for concept development and data review, maintaining an active role in all aspects of development.
• Maintain Centers for Medicare & Medicaid Services (CMS) and Commercial documents, working in tandem with cross-functional teams to ensure quality expectations are met.
• Responsibility for data analytics and knowledge of claim selection, interpreting and converting data into a readable and understandable format. Research, analyze, assess, track and report information.
• Verify and validate client requests, inquiries, contracting updates, etc.
• Manage multiple projects at once, providing quick turnaround times and accurate results in a changing environment.
• Assist in project management by tracking deadlines and facilitating communication individually or on behalf of the SME.
• Develop documentation, workflows, and training materials.
• Comply with company policies, processes, and procedures.
• Provide support for leadership through reports and presentations.
• Stay current on industry standards, regulations, and best practices.
• Analyze data sets to identify trends, anomalies, and opportunities.
• Collaborate with cross-functional teams to develop solutions and optimize processes.

Knowledge, Skills and Abilities Needed

• Self-starter that is passionate about working in the payment integrity space.
• Experienced in data analytics and knowledge of claim selection.
• Ability to work independently and as part of a team.
• Ability to interpret data and convert into a readable and understandable format.
• Ability to research, analyze, assess, track and report information.
• Quick learner that possesses a strong analytical aptitude with a basic understanding of statistics and other mathematical techniques.
• Excellent communicator with skills that can translate complex technical discussions into plain English and communicate verbally with clients and other engineers working together on a project.
• Strong interpersonal skills: ability to communicate effectively through verbal and written correspondence within all levels of the organization and with internal business partners.
• Demonstrated competence developing and improving operational and technical workflow, procedures, and training materials and tools.
• Capability of working in a fast-paced environment, flexibility with assignments and the ability to adapt in a changing environment.

Required & Preferred Qualifications

• High School Diploma is required; Bachelors degree preferred.
• At least 3 years of relevant experience is required; 5 years or more is preferred.
• Proficient in Data Analytic software such as SQL, Insight, DPE.
• Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint, Outlook).
• Excellent organizational and time-management skills.
• Strong communication and interpersonal abilities.
• Strong analytical and problem-solving skills, including the ability to analyze health services utilization data (e.g., claims data).
• Excellent critical thinking skills with attention to detail.
• Flexibility to handle non-standard situations and is adaptable to changing business needs in a fast-paced dynamic environment.
• Must possess excellent time management skills for managing multiple tasks simultaneously, while completing work on time.
• Must be able to work independently in a remote environment utilizing standard office computers and other technologies as applicable.
• Payment integrity experience and/or Coding certification(s) preferred.
• Experience in applying CMS or Commercial Health Plan policy preferred.
• Extensive knowledge of ICD-10-CM/PCS, CPT-4, and HCPCS coding preferred.
• Knowledge of the national coding standards and related payment rules preferred.
• Demonstrated ability to apply complex policies, procedures, regulations, and relevant provider contract language, as appropriate, is preferred.

WHAT WE OFFER:

Performant offers a wide range of benefits to help support a healthy work/life balance. These benefits include medical, dental, vision, disability coverage options, life insurance coverage, 401(k) savings plans, paid family/parental leave, 11 paid holidays per year, as well as sick time and vacation time off annually. For more information about our benefits package, please refer to our benefits page on our website or ask your Talent Acquisition contact during an interview.

Physical Requirements & Additional Notices:

If working in a hybrid or fully remote setting, access to reliable, secure high-speed Internet at your home office location is required. Proof of such may be required prior to an offer being made. It is the Employee's responsibility to maintain this Internet access at their home office location.

The following is a general summary of the physical demands and requirements of an Office/Clerical/Professional or similar job, whether completed remotely at a home office or in a typical on-site professional office environment. This is not intended to be an exhaustive list of requirements, as physical demands of each individual job may vary.

• Regularly sits at a desk during scheduled shift, uses office phone or headset provided by the Company for phone calls, making outbound calls and answering inbound return calls using an office phone system; views a computer monitor, types on a keyboard and uses a computer mouse.
• Regularly reads and comprehends information in electronic (computer) or paper form (written/printed).
• Regularly sit/stand 8 or more hours per day.
• Occasionally lift/carry/push/pull up to 10lbs.

Performant is a government contractor and subject to compliance with client contractual and regulatory requirements, including but not limited to, Drug Free Workplace, background requirements, and other clearances (as applicable). As such, the following requirements will or may apply to this position:

• Must submit to, and pass, a pre-hire criminal background check and drug test (applies to all positions). Ability to obtain and maintain client required clearances, as well as pass regular company background and/or drug screenings post-hire, may be required for some positions.
• Some positions may require the total absence of felony and/or misdemeanor convictions. Must not appear on any state/federal debarment or exclusion lists.
• Must complete the Performant Teleworker Agreement upon hire and adhere to the Agreement and all related policies and procedures.
• Other requirements may apply.

All employees and contractors for Performant Financial may and/or will have access to Sensitive, Proprietary, Confidential and/or Public data. As such, all employees and contractors will have ownership and responsibility to report any violations to the Confidentiality and Integrity of Sensitive, Proprietary, Confidential and/or Public data at all times. Violations to Performant's policy related to the Confidentiality or Integrity of data may be subject to disciplinary actions up to and including termination.

Performant is committed to the full inclusion of all qualified individuals. In keeping with our commitment, Performant will take the steps to assure that people with disabilities are provided reasonable accommodations. Accordingly, if you believe a reasonable accommodation is required to fully participate in the job application or interview process, to perform the essential functions of the position, and/or to receive all other benefits and privileges of employment, please contact Performant's Human Resources team to discuss further.

Our diversity makes Performant unique and strengthens us as an organization to help us better serve our clients. Performant is committed to creating a diverse environment and is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, age, religion, gender, gender identity, sexual orientation, pregnancy, age, physical or mental disability, genetic characteristics, medical condition, marital status, citizenship status, military service status, political belief status, or any other consideration made unlawful by law.

THIRD PARTY RECRUITMENT AGENCY SUBMISSIONS ARE NOT ACCEPTED