Company : AHIPL Agilon Health India Private Limited Job Posting Location : India_Bangalore Job Title : Senior Insights Engineer Job Description : Position Summary: As an Insights Engineer at agilon, and you will build the infrastructure, reports, and dashboards to analyze critical aspects of the business. You will be an expert leader in healthcare quality metrics and processes at agilon, including Star Ratings, HEDIS/NCQA measure logic, and the common data sources that drive their calculations. You will work in with other teams such as Finance, Clinical Analytics, and Central Operations to analyze the quality program at agilon, and develop the dashboards they need to do their daily work. Essential Job Functions: Develop analytical data pipelines and production-grade dashboards to support agilon s quality management program Become an expert in the complex system of quality and pay-for-performance metrics in value-based care Be part of an agile team working collaboratively with agilon leadership and many different cross-functional teams, including UX, Product, Technology, Operations, and our Clinician teams Leverage your analytical thinking to explore our datasets, test hypotheses, and provide insights on how to improve quality management Required Qualifications: Minimum Experience 4+ years experience performing data analysis and generating intuitive reports for common quality metrics in the healthcare domain: e.g. NCQA, STARs, HEDIS, risk adjustment, clinical analytics, or health economics Education/Licensure Bachelor s and/or master s in a quantitative field, such as Computer Science, Data Science, Economics, or Mathematics. Knowledge, Skills, and Abilities: Highly proficient in SQL skills (prefer Snowflake + dbt) and data modeling. Experience with data visualization tools (prefer Sigma). High attention to detail in analytical deliverables and logic, including the ability to parse complex documentation into precise SQL scripts. Deep understanding of quality metrics in US value-based care system, and knowledge of common healthcare concepts and data-sources. Intellectual curiosity and a passion for using data to solve real-world problems at scale. Excellent communication skills and the ability to proactively explain complex analyses to non-technical stakeholders. Enthusiasm for learning and adapting in a dynamic startup environment. Location : India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Prospective Chart Review Quality Auditor Job Description: Performs audits of pre-visit medical record reviews to identify chronic conditions reported in prior years and conditions that lack supporting documentation. Evaluates suggestions or clinical alerts presented by Prospective Chart reviewers, ensure that these suggestions meet specificity requirements to support clinical indicators and in compliance with Risk Adjustment documentation standards. Conducts review and communicates feedback to professionals such as Clinical Chart Reviewers and third-party vendors. Responds to questions submitted by Prospective Chart reviewers. Document detailed audit findings including all errors and missed opportunities in the Prospective chart reviews. Correlate activities, processes and HCC results/ metrics to evaluate outcomes. Assist in developing workflows, curriculum and policies and procedures related to the Pre-visit Medical Record review team. Other Job Functions: Understand, adhere to, and implement the Company’s policies and procedures. Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded. Take personal responsibility for personal growth including acquiring new skills, knowledge, and information. Engage in excellent communication which includes listening attentively and speaking professionally. Set and complete challenging goals. Demonstrate attention to detail and accuracy in work product. Required Qualifications: Minimum Experience 2+ years of clinical experience required 5+ year of chart review and medical coding/auditing experience required Advanced level of clinical knowledge associated with chronic disease states required Education/Licensure: Medical doctor or Nurse required Coding Certification through AHIMA or AAPC required CPC or CPMA preferred Skills and Abilities: Ability to be a team player and exercise initiative in responding to provider requests and concerns in a helpful and courteous manner Provider contracting and customer service techniques General understanding of the health care industry, ideally the provider relations field-desired Excellent interpersonal and telephone communication skills are required Exercise attention to detail; ability to provide accurate data entry Ability to work under pressure with minimal supervision, multi-task, complete projects in a timely fashion and meet deadlines a must Excellent analytical, problem solving and organizational skills a must. Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint) Location: India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Facilities Lead Job Description: Key Responsibilities: Supervise and manage the daily operations of all facilities (housekeeping, security, pantry, maintenance, etc.) Coordinate preventive and corrective maintenance activities for infrastructure. Manage relationships with service providers, contractors, and vendors, monitor SLAs and AMCs. Ensure workplace safety, cleanliness, and regulatory compliance (fire safety, health, statutory requirements, etc.) Oversee seating arrangements, space planning, and workstation management. Manage office supplies and inventory of consumables, ensuring timely procurement and optimal stock levels. Handle facility-related escalations and resolve them efficiently. Support in planning and execution of office events, relocations, and infrastructure upgrades. Monitor utility usage and implement cost-saving measures wherever possible. Maintain accurate records of facility operations, budgets, and vendor agreements. Prepare regular reports and dashboards for management review. Required Qualifications: Bachelor’s degree in any discipline (Facilities Management certification is a plus) 6+ years of experience in facilities or administrative roles, preferably in a corporate setting Strong knowledge of facility systems and maintenance procedures Experience in vendor management and contract handling Excellent communication and interpersonal skills Strong problem-solving and organizational abilities Proficient in MS Office (Excel, Word, PowerPoint) Preferred Attributes: Proactive, self-motivated, and able to work independently Attention to detail and ability to handle emergency situations Familiarity with environment, health & safety (EHS) protocols Location: India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Prospective Chart Reviewer-6 Job Description: Essential Job Functions: Performs pre-visit medical record reviews to identify chronic conditions reported in prior years Identify diagnoses that lack supporting documentation Prioritizes clinical alerts and presents those that are strongly suggestive of an underlying condition Present information to providers in a concise complete manner All other duties as assigned Other Job Functions: Understand, adhere to, and implement the Company’s policies and procedures. Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded. Take personal responsibility for personal growth including acquiring new skills, knowledge, and information. Engage in excellent communication which includes listening attentively and speaking professionally. Set and complete challenging goals. Demonstrate attention to detail and accuracy in work product by meeting productivity standards and maintaining a company standard of accuracy Qualifications: Minimum Experience 2+ years of clinical experience required Advanced level of clinical knowledge associated with chronic disease states required Relevant chart review experience required Education/Licensure: Medical Doctor or Nurse required Coding Certification through AHIMA or AAPC preferred Skills and Abilities: Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint) Location: India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: Prospective Chart Reviewer-6 Job Description: Essential Job Functions: Performs pre-visit medical record reviews to identify chronic conditions reported in prior years Identify diagnoses that lack supporting documentation Prioritizes clinical alerts and presents those that are strongly suggestive of an underlying condition Present information to providers in a concise complete manner All other duties as assigned Other Job Functions: Understand, adhere to, and implement the Company’s policies and procedures. Provide excellent customer services skills, including consistently displaying awareness and sensitivity to the needs of internal and/or external clients. Proactively ensuring that these needs are met or exceeded. Take personal responsibility for personal growth including acquiring new skills, knowledge, and information. Engage in excellent communication which includes listening attentively and speaking professionally. Set and complete challenging goals. Demonstrate attention to detail and accuracy in work product by meeting productivity standards and maintaining a company standard of accuracy Qualifications: Minimum Experience 2+ years of clinical experience required Advanced level of clinical knowledge associated with chronic disease states required Relevant chart review experience required Education/Licensure: Medical Doctor or Nurse required Coding Certification through AHIMA or AAPC preferred Skills and Abilities: Language Skills: Strong communication skills both written and verbal to work with multiple internal and external clients in a fast-paced environment Mathematical Skills: Ability to work with mathematical concepts such as probability and statistical inference. Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations. Reasoning Ability: Ability to apply principles of logical or scientific thinking to a wide range of intellectual and practical problems. Computer Skills: Ability to create and maintain documents using Microsoft Office (Word, Excel, Outlook, PowerPoint) Location: India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: HEDIS Abstractor and Overreader Job Description: Position Summary: The HEDIS Abstractor and Overreader is responsible for the HEDIS Medical Record Review (MRR) process which includes accurately reviewing and abstracting medical records to determine compliance with HEDIS measure specifications, as well as conducting overreads to ensure data quality, consistency and adherence to NCQA guidelines. This role will work closely with internal and external stakeholders to ensure medical charts meet standards as outlined by HEDIS specifications and will partner with health plans to understand correct and consistent implementation of audit and testing processes for HEDIS measures. Essential Job Functions: Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications Perform overreads of abstracted medical records for accuracy, completeness and measure compliance Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement Support audit preparation and participate in internal quality reviews and training sessions Manages all activities to meet health plan contractual and reporting timeframes Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership Other Job Functions: Other duties as assigned. Required Qualifications: Minimum Experience Minimum of 2 years’ experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools Familiarity with Medicare Advantage lines of business and Stars Measures Familiarity with supplemental data processes and quality data integration Education & Licensure Minimum of Bachelor’s degree or equivalent degree Skills and Abilities: Ability to be a team player and exercise initiative in responding to team members or Sr. Manager. Thorough understanding of medical record documentation and medical terminology High level of attention to detail and ability to follow direction on project deadlines Ability to work independently Strong language skills in English speaking and understanding Ability to meet high productivity requirements and Interrater Reliability standards Strong Excel skills Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts. Ability to apply deep level of measure understanding to legal medical records Strong Adobe skills (including saving records in PDF format and annotation) Ability to interpret large data files for needed abstraction Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls Location: India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: HEDIS Abstractor and Overreader Job Description: Position Summary: The HEDIS Abstractor and Overreader is responsible for the HEDIS Medical Record Review (MRR) process which includes accurately reviewing and abstracting medical records to determine compliance with HEDIS measure specifications, as well as conducting overreads to ensure data quality, consistency and adherence to NCQA guidelines. This role will work closely with internal and external stakeholders to ensure medical charts meet standards as outlined by HEDIS specifications and will partner with health plans to understand correct and consistent implementation of audit and testing processes for HEDIS measures. Essential Job Functions: Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications Perform overreads of abstracted medical records for accuracy, completeness and measure compliance Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement Support audit preparation and participate in internal quality reviews and training sessions Manages all activities to meet health plan contractual and reporting timeframes Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership Other Job Functions: Other duties as assigned. Required Qualifications: Minimum Experience Minimum of 2 years’ experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools Familiarity with Medicare Advantage lines of business and Stars Measures Familiarity with supplemental data processes and quality data integration Education & Licensure Minimum of Bachelor’s degree or equivalent degree Skills and Abilities: Ability to be a team player and exercise initiative in responding to team members or Sr. Manager. Thorough understanding of medical record documentation and medical terminology High level of attention to detail and ability to follow direction on project deadlines Ability to work independently Strong language skills in English speaking and understanding Ability to meet high productivity requirements and Interrater Reliability standards Strong Excel skills Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts. Ability to apply deep level of measure understanding to legal medical records Strong Adobe skills (including saving records in PDF format and annotation) Ability to interpret large data files for needed abstraction Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls Location: India_Bangalore
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: HEDIS Abstractor and Overreader Job Description: Position Summary: The HEDIS Abstractor and Overreader is responsible for the HEDIS Medical Record Review (MRR) process which includes accurately reviewing and abstracting medical records to determine compliance with HEDIS measure specifications, as well as conducting overreads to ensure data quality, consistency and adherence to NCQA guidelines. This role will work closely with internal and external stakeholders to ensure medical charts meet standards as outlined by HEDIS specifications and will partner with health plans to understand correct and consistent implementation of audit and testing processes for HEDIS measures. Essential Job Functions: Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications Perform overreads of abstracted medical records for accuracy, completeness and measure compliance Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement Support audit preparation and participate in internal quality reviews and training sessions Manages all activities to meet health plan contractual and reporting timeframes Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership Other Job Functions: Other duties as assigned. Required Qualifications: Minimum Experience Minimum of 2 years’ experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools Familiarity with Medicare Advantage lines of business and Stars Measures Familiarity with supplemental data processes and quality data integration Education & Licensure Minimum of Bachelor’s degree or equivalent degree Skills and Abilities: Ability to be a team player and exercise initiative in responding to team members or Sr. Manager. Thorough understanding of medical record documentation and medical terminology High level of attention to detail and ability to follow direction on project deadlines Ability to work independently Strong language skills in English speaking and understanding Ability to meet high productivity requirements and Interrater Reliability standards Strong Excel skills Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts. Ability to apply deep level of measure understanding to legal medical records Strong Adobe skills (including saving records in PDF format and annotation) Ability to interpret large data files for needed abstraction Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls Location: India_Bangalore
You will be working as a Business Support Analyst at MPHIN My Personal Health Record Express India Pvt. Ltd. in Gurgaon, India. Your primary responsibilities will include: - Serving as the initial point of contact for clients regarding issues, escalations, inquiries, and support related to products or services through various communication channels. - Monitoring the application and system health on a regular basis, ensuring continuous coverage. - Analyzing multiple monitoring system events and application statuses to diagnose issues accurately. - Assessing the severity and urgency of incidents and taking prompt action to restore services, escalating to Engineering staff when necessary within defined SLAs. - Ensuring adherence to established communication protocols during system impacting events. - Identifying areas for process improvements and offering recommendations for enhancement. - Being available for shifts, working on holidays, and taking on-call responsibilities as part of the 24x7x365 operational model. To be successful in this role, you should have: - 3-10 years of experience in global client support with a customer-centric approach. - Strong verbal and written communication skills and proficiency in handling customer/client interactions via email, ticketing system, and telephone. - Understanding of Service Level Agreements and ability to work towards meeting and exceeding service levels consistently. - Proficiency in structured query language and the capability to analyze data by navigating databases for troubleshooting purposes. - Exceptional analytical and problem-solving skills within defined timelines. - Willingness to learn new technologies to support business requirements. - Ability to work in a 24x7 environment on a rotational basis. - Team player mindset with a track record of delivering exceptional results under pressure. - Knowledge of Linux basics and familiarity with MongoDB queries would be advantageous. If you are looking for a challenging role that requires strong communication skills, analytical thinking, and a proactive approach to problem-solving, this position is an excellent opportunity for you.,
Company: AHIPL Agilon Health India Private Limited Job Posting Location: India_Bangalore Job Title: HEDIS Abstractor and Overreader Job Description: Position Summary: The HEDIS Abstractor and Overreader is responsible for the HEDIS Medical Record Review (MRR) process which includes accurately reviewing and abstracting medical records to determine compliance with HEDIS measure specifications, as well as conducting overreads to ensure data quality, consistency and adherence to NCQA guidelines. This role will work closely with internal and external stakeholders to ensure medical charts meet standards as outlined by HEDIS specifications and will partner with health plans to understand correct and consistent implementation of audit and testing processes for HEDIS measures. Essential Job Functions: Review and abstract clinical data from electronic medical records in alignment with HEDIS technical specifications Perform overreads of abstracted medical records for accuracy, completeness and measure compliance Demonstrate high level of proficiency in HEDIS measures and coding standards (including but not limited to ICD-10, CPT and CPTII) to close gaps in care Collaborate with internal and external partners to resolve documentation discrepancies and provide recommendations for improvement Support audit preparation and participate in internal quality reviews and training sessions Manages all activities to meet health plan contractual and reporting timeframes Identify trends in abstraction that may impact measure performance or audit readiness and proactively escalate to leadership Other Job Functions: Other duties as assigned. Required Qualifications: Minimum Experience Minimum of 2 years’ experience working with NCQA HEDIS programs and/or HEDIS abstraction in all measures Proficiency in EMR platforms (i.e., Epic, Cerner) and abstraction tools Familiarity with Medicare Advantage lines of business and Stars Measures Familiarity with supplemental data processes and quality data integration Education & Licensure Minimum of Bachelor’s degree or equivalent degree Skills and Abilities: Ability to be a team player and exercise initiative in responding to team members or Sr. Manager. Thorough understanding of medical record documentation and medical terminology High level of attention to detail and ability to follow direction on project deadlines Ability to work independently Strong language skills in English speaking and understanding Ability to meet high productivity requirements and Interrater Reliability standards Strong Excel skills Ability to interpret compliance vs non-compliance on health plan gap file use to direct abstraction efforts. Ability to apply deep level of measure understanding to legal medical records Strong Adobe skills (including saving records in PDF format and annotation) Ability to interpret large data files for needed abstraction Deep level of ability to recognize medical records that are not complete or are missing needed data points in overreading Ability to report clearly on both positive or negative findings and apply possible solutions on Team calls Location: India_Bangalore