Hybrid Concept Ideation Analyst Concept Ideation Analyst with verification

As a Concept Ideation Analyst, you will lead the development of innovative Payment Integrity ideas and concepts to drive strategic initiatives and business growth. This role will work with multiple clients, and drive business by management of a client’s end to end experience. Creating analytics and aligning with client goals to drive post pay savings by leveraging your expertise in market analysis, creative thinking, and strategic planning, you will collaborate with cross-functional teams to identify emerging trends, customer needs, and market opportunities. This role requires a combination of visionary thinking, analytical rigor, and leadership skills to shape the future direction of the organization's products and initiatives.

Benefits:

• Remote-first flexible working environment
• Health insurance, including $0 premium HDHP and $0 deductible PPO options
• Vision, Dental
• Company-paid Telemedicine
• Company-paid Life Insurance
• Company-paid STD
• Voluntary LTD
• Voluntary Life Insurance
• FIRST-DAY COVERAGE for all benefits above
• 401(k) with matching, immediate vesting
• Generous Paid Time Off, including Vacation, Wellness, Floating Holidays, and Volunteer Time Off

You may be ideal if you have:

• 1 year minimum of robust experience in the dynamic field of health insurance payment integrity, demonstrating a proven track record of success and proficiency.
• CPC strongly preferred.
• In-depth understanding of claim coding intricacies, encompassing CPT, HCPCS, ICD-10 codes, and modifiers, showcasing expertise essential for accurate claim analysis.
• Proficiency in various claim reimbursement methodologies, including DRG, OPPS, APC, NCCI Edits, MUE’s, and highlighting a comprehensive grasp of reimbursements.
• Demonstrated adaptability and capability to swiftly learn and proficiently navigate multiple payer systems and applications, ensuring seamless integration and efficiency in daily operations.
• Possesses intermediate Excel skills, enabling effective data analysis and manipulation to extract meaningful insights and drive informed decision-making processes.

Responsibilities:

• Identify, analyze, and explain medical trends using claims-based analyses
• Perform data analytics in support of medical expense insights, clinical initiatives, and affordability program development and validation
• Apply strong critical thinking and listening skills to anticipate questions from key stakeholders and consider all aspects of an analysis before completion
• Research healthcare topics and incorporate findings into data analyses
• Construct polished MS Excel models to satisfy analytical requests
• Provide consistent, timely, and meaningful communications to requestors on projects status, results, and conclusions from analyses
• Take ownership of ambiguous concepts and completing analysis with limited supervision
• Be a creative disrupter with a growth mindset to collaboratively reimagine the way we operate to generate value.

Other Duties: This job description in no way states or implies that these are the only duties to be performed by this employee. This position will require you to follow other instructions and perform other duties requested by his/her supervisor. Individuals will always be expected to maintain a professional work environment.

About ClarisHealth:

ClarisHealth, based in Nashville, Tenn., provides health plans and payers with a better way to drive claims payment accuracy. Its proprietary, A.I.-powered enterprise technology platform Pareo® allows health plans across the U.S. to reduce manual work, gain insights into operational performance across lines of business, and accelerate their strategy to overpayment prevention – at a significantly reduced cost.

Company Culture:

Our company values help everyone move in alignment toward this mission. We are …

Compassionate. We practice servant leadership, encourage inclusion and engagement, and actively acknowledge and celebrate each other’s contributions.

Communicators. We listen first with an emphasis on understanding. We seek solutions to problems, and practice radical candor with positive intent.

Challengers. We get the right stuff done right, create clarity from complexity, take accountability and ownership, and we challenge ourselves daily.

ClarisHealth embraces a supportive working culture of creativity and innovation internally termed “Got Your Back.” We live out this #GYB spirit every day by working together with team members, clients, and other partners to achieve shared goals.

For more information about ClarisHealth and our culture, please visit us at https://www.clarishealth.com/careers/.

Other:

Applicants must be currently authorized to work in the United States on a full-time basis. ClarisHealth is not able to sponsor applicants for work visas.

EOE, including Disability/Veterans; anyone needing accommodation to complete the interview process should notify the People Operations team.