Consultant Technical Analyst - Population Health and Care Management

Company Description

IKAI Technology Solutions supports businesses in leveraging information technology across North America, Europe, and Asia-Pacific regions. We are committed to revolutionizing the digital landscape for our clients with extensive experience in managing global enterprises. Our focus is on continuous improvement, building digital skills, and fostering a culture of innovation. At IKAI, we guide organizations toward success amidst the complexities of today's technology-driven world.

Job Summary:

o Must demonstrate strong domain expertise, particularly in the Payor-Provider ecosystem, with a solid understanding of Medicare, Medicaid, and other relevant healthcare programs o Works with stakeholders to discover, clarify, and document current and future data needs o Performs mapping of Population Health and Care Management data to a normalized data model. o Serves as a subject matter expert on the Population health data domains such as Care Management, Utilization Management, Quality Scores, HEDIS, Care gaps o Builds data concepts to support Population Health use cases o Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.

Responsibilities:

○ Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards ○ Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues ○ Works with customers to clarify and plan for their current and future technology needs. Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system. ○ Designs and implements projects requiring systems integration, small teams and multiple technical platforms. ○ Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization. ○ Collaborates on driving improvement activities to achieve department and organizational goals. ○ Coordinates with functional team to assure consistency and optimization of overall work product ○ Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value. ○ Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes. ○ Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation ○ Identifies opportunities for process improvement and makes recommendations that lead to improvements ○ Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality. ○ Escalates process and project issues that cannot be resolved

Experience:

○ Prior experience working as a Population Health analyst in the Healthcare system. ○ Must have a working knowledge of relational databases/database structures, SQL expertise desired ○ Must have a strong understanding of data collected and used in Claims, Adjudications, Health Insurance and Care and Utilization Management ○ Knowledge and experience with ambulatory and acute clinical, billing and claims workflows and clinical information systems. ○ Bachelor or Masters degree in related health or finance field ex informatics or bioinformatics. ○ Complexity of work: Within the scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment. ○ 5 years of experience preferred