POSITION SUMMARY

This position provides expertise in Health Plan processes and participates in formulating system scope and objectives relative to the company’s requirements. Works as part of a team who provides knowledge, guidance, research and fact finding expertise to define, design and modify specifications and processes of information systems. Incumbent participates in establishing system documentation standards and quality assurance methodologies for Health Plan systems and applications.

MINIMUM QUALIFICATIONS

Knowledge, skills and abilities as normally obtained through the completion of a Bachelor’s Degree in IT or related field and five or more years of IT experience within the healthcare industry, with one to two years of experience within Population Health Organization.
Experience in implementation and/or support of Population Health systems/solutions, such as but not limited to: Risk Stratification Registries, Case Management Systems, Claims Adjudication Systems, IVR technology, Prior Authorization, etc.
General knowledge and understanding of value based care and accountable care concepts, and of different healthcare plans (Medicare, Medicaid and Commercial Plans). Experience interacting with providers of healthcare service, payors and affiliated networks.

PREFERRED QUALIFICATIONS

General knowledge of value based care and accountable care concepts preferred.
Additional related education and/or experience preferred.

Please refer the Job description for details