Consultant - IV&V, NPI, MITA, HIPAA, SACWIS, Medicaid

Consults with client to define need or problem, conducts studies and surveys to obtain data, and analyzes data to advise on or recommend solution by performing the following duties

Collects, documents, and analyzes information concerning clients current clinical, financial or business processes and information systems.

Identifies and documents deficiencies and dysfunctionality in existing clinical, financial or business processes and information systems.

Develops alternatives for solutions to problems and, where appropriate, assists in implementing improved or new business processes or automated systems.

Defines, tests, and implements solutions to business and systems problems.

Analyzes data to determine solution such as installation of alternate methods and procedures as well as make changes in processing methods and practices. Make modification or redesign of products or services.

Advises client on alternate methods of solving needs or problem, or recommends specific solutions.

Assists in identifying new business opportunities and in developing and presenting proposals to prospective clients.

5 - 7 years of experience working in managed care organizations or regulatory agencies

Experience conducting JAD sessions

Knowledge and experience in healthcare utilization review and fraud and abuse

Skills in information technology requirements analysis and design, facilitation and modeling,

Strategic systems planning

Healthcare operations including claims, utilization review, peer review and accreditation

Solid writing skills and experience conducting group presentations

EDUCATION and/or EXPERIENCE
Bachelor's degree (B. A.) from four-year College or university; or one to two years related experience and/or training; or equivalent combination of education and experience.

Extensive travel required

To apply online go to https://home.eease.com/recruit/?id=18442