Company:
Diverse Lynx
Location: Hartford
Closing Date: 30/11/2024
Hours: Full Time
Type: Permanent
Job Requirements / Description
Responsibilities:
Collaborate with cross-functional teams to understand healthcare business requirements and translate them into technical specifications
Provide domain expertise to inform the design, development, and implementation of IT solutions tailored to the healthcare industry.
Conduct thorough analysis of existing healthcare workflows and systems to identify areas for improvement and optimization.
Act as a liaison between healthcare stakeholders and IT teams to facilitate effective communication and alignment of objectives.
Stay updated on industry trends, regulations, and best practices within the healthcare domain to inform strategic decision-making.
Lead training sessions and workshops to educate stakeholders on new IT solutions and ensure successful adoption within the healthcare environment.
Identifies opportunities to enhance assets that deliver operational efficiencies to the business and leads its implementation
Understands issues facing the business that would affect digital assets/ core systems and peripherals and develop strategic solutions for implementation
Qualifications:
Experience in cross-functional solution architecture and development, focused on delivering high-quality IT solutions for health Insurance players
In-depth Knowledge of Healthcare Insurance and systems. This includes familiarity with various types of insurance plans (e.g., HMOs, PPOs, Medicare, Medicaid) and their respective requirements.
Proficiency in healthcare insurance concepts like member enrollment, claims processing, denial management, care management, medical management and clinical support
Understanding of Healthcare Regulations such as HIPAA, ACA, and state-specific insurance regulations. This includes staying updated on regulatory changes and ensuring compliance with industry standards.
Experience / knowledge of interoperability standards, such as HL7 C-CDA and FHIR
Experience with clinical concepts, such as SNOMED-CT, ICD10, CPT and RXNORM
Stakeholder Management: Strong interpersonal skills and the ability to communicate effectively with internal teams, external partners, and policyholders
Ability to address complex challenges and make data-driven decisions to optimize healthcare insurance operations.
Experience in responding RFIs and RFPs
Staying updated on industry trends, emerging technologies, and best practices in healthcare insurance.
Good to Have-
Minimum of 8 years of experience working in the healthcare industry, with a deep understanding of healthcare processes, regulations, and challenges.
Experience in developing strategies to improve efficiency, reduce costs, and enhance the quality of insurance services is valuable.
Strong analytical and problem-solving skills, with the ability to assess complex healthcare scenarios and propose innovative technology-driven solutions.
Certification in relevant healthcare IT systems (e.g., Epic, Cerner, Meditech) is a plus.
Familiarity with Agile methodologies and project management principles is desirable. Excellent collaboration, influencing, and consensus-building skills. Ability to work with persons in all job functions (e.g. product, program, developers, etc).
Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.
Responsibilities:
Collaborate with cross-functional teams to understand healthcare business requirements and translate them into technical specifications
Provide domain expertise to inform the design, development, and implementation of IT solutions tailored to the healthcare industry.
Conduct thorough analysis of existing healthcare workflows and systems to identify areas for improvement and optimization.
Act as a liaison between healthcare stakeholders and IT teams to facilitate effective communication and alignment of objectives.
Stay updated on industry trends, regulations, and best practices within the healthcare domain to inform strategic decision-making.
Lead training sessions and workshops to educate stakeholders on new IT solutions and ensure successful adoption within the healthcare environment.
Identifies opportunities to enhance assets that deliver operational efficiencies to the business and leads its implementation
Understands issues facing the business that would affect digital assets/ core systems and peripherals and develop strategic solutions for implementation
Qualifications:
Experience in cross-functional solution architecture and development, focused on delivering high-quality IT solutions for health Insurance players
In-depth Knowledge of Healthcare Insurance and systems. This includes familiarity with various types of insurance plans (e.g., HMOs, PPOs, Medicare, Medicaid) and their respective requirements.
Proficiency in healthcare insurance concepts like member enrollment, claims processing, denial management, care management, medical management and clinical support
Understanding of Healthcare Regulations such as HIPAA, ACA, and state-specific insurance regulations. This includes staying updated on regulatory changes and ensuring compliance with industry standards.
Experience / knowledge of interoperability standards, such as HL7 C-CDA and FHIR
Experience with clinical concepts, such as SNOMED-CT, ICD10, CPT and RXNORM
Stakeholder Management: Strong interpersonal skills and the ability to communicate effectively with internal teams, external partners, and policyholders
Ability to address complex challenges and make data-driven decisions to optimize healthcare insurance operations.
Experience in responding RFIs and RFPs
Staying updated on industry trends, emerging technologies, and best practices in healthcare insurance.
Good to Have-
Minimum of 8 years of experience working in the healthcare industry, with a deep understanding of healthcare processes, regulations, and challenges.
Experience in developing strategies to improve efficiency, reduce costs, and enhance the quality of insurance services is valuable.
Strong analytical and problem-solving skills, with the ability to assess complex healthcare scenarios and propose innovative technology-driven solutions.
Certification in relevant healthcare IT systems (e.g., Epic, Cerner, Meditech) is a plus.
Familiarity with Agile methodologies and project management principles is desirable. Excellent collaboration, influencing, and consensus-building skills. Ability to work with persons in all job functions (e.g. product, program, developers, etc).
Diverse Lynx LLC is an Equal Employment Opportunity employer. All qualified applicants will receive due consideration for employment without any discrimination. All applicants will be evaluated solely on the basis of their ability, competence and their proven capability to perform the functions outlined in the corresponding role. We promote and support a diverse workforce across all levels in the company.
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