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HIS Clinical Analyst – Ambulatory Procedure Methodology Groupers

Remote - Texas, United States

Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a new company named Solventum. We are still in the process of updating our Careers Page and applicant documents, which currently have 3M branding. Please bear with us. In the interim, our Privacy Policy here: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ continues to apply to any personal information you submit, and the 3M-branded positions listed on our Careers Page are for Solventum positions. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

Job Description:

Job Title: Solventum HIS Clinical Analyst – Ambulatory Procedure Methodology Groupers

3M Health Care is now Solventum

At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue.

We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you.

The Impact You Will Make in this Role

Solventum HIS is an international leader in designing and maintaining healthcare payment and quality outcome systems and advancing value-based care. We work closely with Medicare, Medicaid and commercial insurers on hospital, outpatient and population payment models and design quality outcome programs that promote patient safety and reduce avoidable costs. We also support more than ten countries on how they budget and pay for inpatient and outpatient care, and measure healthcare quality. Here, you will make an impact by:

· Providing the lead subject matter expertise in the clinical content development, specification, documentation, validation, application, and maintenance of the Solventum Ambulatory Potentially Preventable Complications (Solventum™ AM-PPCs) measure which examines potentially preventable complications across a wide range of ambulatory procedures. These methodologies utilize healthcare data, diagnostic and procedural codes, which are employed by payers for quality and performance-based payments, and by healthcare systems for clinical documentation improvement (CDI), quality control, and care management. The methodology is also used by US News and World Report in its Best Hospitals ranking program.

· Contributing and coordinating with the research efforts related to the methodologies, provide input into the prioritization of the potential research enhancements.

· Work directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating the clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications.

· Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and evaluate the clinical specification.

· Responsible for maintaining process documentation for the methodologies update using C&ER standards and methods.

Your Skills and Expertise

To set you up for success in this role from day one, Solventum is looking for candidates who must have the following qualifications:

  • Bachelor’s Degree or higher and 5 years’ experience in the healthcare industry, in quality improvement, patient safety medical coding, or health care services research.

  • Working with quality outcomes, quality measures, clinical-coding, or case mix patient classification measures·

Additional qualifications that could help you succeed even further in this role include:

· Master's degree in health field, clinical informatics, clinical coding, and/or HIM credentials.

Ability to collaborate with a diverse professional team, including researchers, healthcare providers, and engineers.

· Experience working with excel, databases, and ability to learn computer applications for analysis.

· Healthcare payer, delivery or industry experience in healthcare quality, population health, care management,

· Familiarity with patient classification research and development:

o Outpatient coding and payment systems

o Inpatient coding and payment systems

o Commercial, Medicare and Medicaid environments

o Risk adjustment

· Knowledge of ICD-10-CM, ICD-10-PCS, CPT, HCPCS, NDC code sets

· Experience with healthcare data, coding, billing, and payment

· Ability to evaluate research questions, analyze results and statistical output and patterns, and document hypotheses and recommendations.

· Healthcare software product development experience, bringing products from initial concept to release.

· An ability to effectively communicate ideas, concepts, and information: presenting and training clinical concepts, coding systems and underlying design of patient classification methodologies in healthcare.

· Ability to take individual initiative and responsibility for assignments while working independently and in a team environment.

Work location:

· Remote

Must be legally authorized to work in country of employment without sponsorship for employment visa status (e.g., H1B status).

Supporting Your Well-being

Solventum offers many programs to help you live your best life – both physically and financially. To ensure competitive pay and benefits, Solventum regularly benchmarks with other co

Applicable to US Applicants Only:The expected compensation range for this position is $106,331 - $129,960, which includes base pay plus variable incentive pay, if eligible. This range represents a good faith estimate for this position. The specific compensation offered to a candidate may vary based on factors including, but not limited to, the candidate’s relevant knowledge, training, skills, work location, and/or experience. In addition, this position may be eligible for a range of benefits (e.g., Medical, Dental & Vision, Health Savings Accounts, Health Care & Dependent Care Flexible Spending Accounts, Disability Benefits, Life Insurance, Voluntary Benefits, Paid Absences and Retirement Benefits, etc.). Additional information is available at: https://www.solventum.com/en-us/home/our-company/careers/#Total-Rewards

Responsibilities of this position include that corporate policies, procedures and security standards are complied with while performing assigned duties.

Solventum is committed to maintaining the highest standards of integrity and professionalism in our recruitment process.  Applicants must remain alert to fraudulent job postings and recruitment schemes that falsely claim to represent Solventum and seek to exploit job seekers.

Please note that all email communications from Solventum regarding job opportunities with the company will be from an email with a domain of @solventum.com. Be wary of unsolicited emails or messages regarding Solventum job opportunities from emails with other email domains.

Please note, Solventum does not expect candidates in this position to perform work in the unincorporated areas of Los Angeles County.

Solventum is an equal opportunity employer.  Solventum  will not discriminate against any applicant for employment on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, or veteran status.

Please note: your application may not be considered if you do not provide your education and work history, either by: 1) uploading a resume, or 2) entering the information into the application fields directly.

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Job Profile

Regions

North America

Countries

United States

Restrictions

Must be legally authorized to work Must be legally authorized to work in country Must be legally authorized to work in country of employment Must be legally authorized to work in country of employment without sponsorship Must be legally authorized to work in country of employment without sponsorship for employment visa status Remote

Benefits/Perks

Competitive pay Competitive pay and benefits Dental Disability benefits Flexible Spending Accounts Health Savings Accounts Life Insurance Medical Paid absences Remote-first company Retirement benefits Vision

Tasks
  • Collaborate with teams
  • Coordinate research efforts
  • Develop clinical content
  • Maintain process documentation
  • Process documentation
  • Training
  • Translate clinical hypotheses
Skills

Analysis Applications Billing Branding C Care management Cdi Clinical content development Clinical Documentation Clinical documentation improvement Clinical Informatics Clinical logic specifications Coding Communications Compliance Content development Corporate policies CPT Data Data Science Diagnostic codes Documentation Excel Healthcare Healthcare Data Healthcare industry ICD-10 ICD-10-CM Inpatient Coding IT Medical Coding Prioritization Procedural codes Product Development Quality Control Research Research Coordination Security Technical Technology Training Validation

Experience

3 years

Education

Higher Master's

Certifications

Product Owner

Timezones

America/Anchorage America/Chicago America/Denver America/Los_Angeles America/New_York Pacific/Honolulu UTC-10 UTC-5 UTC-6 UTC-7 UTC-8 UTC-9