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IT Healthcare Consultant - Business Analyst - Advanced - Clinical Analyst

My3Tech

  • Columbia, SC
  • 4 days ago

    Highlights

    May serve as a back-up to other roles within the bureau to support claim escalations research, once the person has demonstrated full proficiency in the job functions required for their new role Other project-related duties, as assigned or required REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE): 3+ years' experience in healthcare Strong knowledge of ICD/CPT/HCPCS translation and coding methodologies 3+ years extensive knowledge of anatomy, physiology, pharmacology, and medical terminology 3+ years of strong knowledge of formal business process documentation PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE): 3+ years' experience healthcare hospital, office and clinic setting Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs) REQUIRED EDUCATION: Bachelor's degree in healthcare related field. May serve as a back-up to other roles within the bureau to support claim escalations research, once the person has demonstrated full proficiency in the job functions required for their new role Other project-related duties, as assigned or required REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE): 3+ years' experience in healthcare Strong knowledge of ICD/CPT/HCPCS translation and coding methodologies 3+ years extensive knowledge of anatomy, physiology, pharmacology, and medical terminology 3+ years of strong knowledge of formal business process documentation PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE): 3+ years' experience healthcare hospital, office and clinic setting Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs) Other: preference for resources that are local to SC, NC, or GA.

    Numbers & Facts

    LocationColumbia, SC

    Description

    Hello All,
    I hope you're doing well.
    Job: IT - SCDHHS - IT Healthcare Consultant - Business Analyst - Advanced - Clinical Analyst
    location:1201 Main Street Suite 600, Columbia South Carolina 29201
    Job ID:13856
    Client: State of SC
    Type: W2
    The State of South Carolina is looking for an IT Healthcare Consultant - Business Analyst - Advanced - Clinical Analyst
    Why is this position open: New position - The position we are seeking to fill is for a candidate with a background in healthcare and is a Certified Medical Coder.
    Will close to submissions on 10/07 at 5:00 PM EST.
    Interview Process: 1 round, Virtual/Online
    Duration of the Contract: 12 months
    Possibility for Extension: Yes
    Work Location: 80% remote, resources will need to come onsite in Columbia, SC to certain trainings/meetings
    Candidate Location: Resource can reside anywhere in the US - must be willing to travel onsite to Columbia, SC within notice from management at the resources expense. Strong preference for resources that are local to SC, NC, or GA.
    Full job description attached & required/preferred skills are stated below.
    COMPANY / DEPARTMENT CULTURE:
    The South Carolina Department of Health & Human Services (SCDHHS) is the State Medicaid Agency for South Carolina. The Business Analyst will support the medical code change requests by researching and making recommendations to policy and process owners and stakeholders for review and approval. The position will also participate as a project team member, as assigned, for related process improvements, Medicaid Management Information System (MMIS) enhancements and provide subject matter expertise for a future MMIS replacement. The position we are seeking to fill is for a candidate with a background in healthcare and is a Certified Medical Coder.
    Candidates who enjoy working on complex, change-oriented projects with motivated team members will find this position attractive.
    WHY IS THIS POSITION OPEN (new role, increased workload, new dept., resignation, promotion)?
    The workload and complexities of the reference administration responsibilities require additional support to maintain efficiency and to achieve defined deliverable dates. The additional position will allow us to finalize succession planning for the Reference Administration team.
    WHAT TYPES OF STAFFING CHALLENGES OR HEADACHES HAVE YOU EXPERIENCED IN THE PAST?
    Recruiters submitting multiple, clearly unqualified candidates.
    This position requires an individual with strong analytical skills and experience in:
    ? Managing multiple work efforts simultaneously
    ? Medical Coding
    ? Clinical background not required but could be beneficial
    ? Time management skills
    ? CPT/HCPCS and ICD-10 translation knowledge and ability to learn how medical codes link to claims processing
    ? Ability to understand business and functional requirements
    Please ensure that your candidates have strength in these areas. Candidates with hospital, office, or clinic settings experience will be beneficial.
    The candidate must have strong collaboration and relationship building skills.
    Experience in healthcare or degree to align with healthcare environment
    SCOPE OF THE PROJECT:
    This project is a multi-year-old effort which primarily focuses on providing consulting services to operations and policy staff for the current Medicaid Management Information System (MMIS).
    The current position's focus and priority is the continued support of serving as a subject matter expert (SME), building knowledge that allows policy and process owners to make the best recommendations for Medicaid members and providers. It is necessary to build and sustain a strong staff who understands coding, aids staff in understanding CPT/HCPCS and ICD-10 coding and apply the codes correctly within the Reference Administration sub-system.
    OBJECTIVES TO BE FULFILLED BY CANDIDATE:
    The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code maintenance. As the IT Healthcare Consultant Business Analyst Advanced (Clinical Analyst and Coding Specialist):
    Specific duties include, but are not limited to:
    Initiates annual (and quarterly) updates from CMS of all ICD-10, CPT/HCPCS coding changes.
    Performs initial review of codes to determine scope of changes.
    Prepares listings of codes changes to Reference Administration staff and Medicaid Program staff for review and analysis.
    Conducts meetings with Agency personnel, stakeholders, and process owners.
    (Future) Participates in DASH (Replacement MMIS) project meetings, as needed, where reference administration expertise is required.
    Serves as an agency subject matter expert (SME) for medical coding methodologies, Medicaid policy, and related topics.
    Research business rules, requirements, and models to complete initial analysis and recommendations.
    Maintains business rules, requirements, and models in a repository.
    Collaborates with team to ensure process documentation is complete, owner and stakeholder, as needed, training content is complete and routinely updated.
    May serve as a back-up to other roles within the bureau to support claim escalations research, once the person has demonstrated full proficiency in the job functions required for their new role
    Other project-related duties, as assigned or required
    REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
    3+ years' experience in healthcare
    Strong knowledge of ICD/CPT/HCPCS translation and coding methodologies
    3+ years extensive knowledge of anatomy, physiology, pharmacology, and medical terminology
    3+ years of strong knowledge of formal business process documentation
    PREFERRED SKILLS (RANK IN ORDER OF IMPORTANCE):
    3+ years' experience healthcare hospital, office and clinic setting
    Knowledge of Microsoft Office (Word, Excel, PowerPoint, Optum Encoder and other medical coding software programs)
    REQUIRED EDUCATION:
    Bachelor's degree in healthcare related field. An equivalent combination of experience and education may be considered with prior SCDHHS hiring team review and approval. REQUIRED CERTIFICATIONS:
    Currently credentialed as CPC (Certified Professional Coder) or as CCS (Certified Coding Specialist).
    OBJECTIVES TO BE FULFILLED BY CANDIDATE:
    The principal duties of this position are to assist with the CPT/HCPCS and ICD-10 code
    maintenance. As the IT Healthcare Consultant Business Analyst Advanced (Clinical Analyst
    and Coding Specialist):
    Specific duties include, but are not limited to:
    Initiates annual (and quarterly) updates from CMS of all ICD-10, CPT/HCPCS coding
    changes.
    Performs initial review of codes to determine scope of changes.
    Prepares listings of codes changes to Reference Administration staff and Medicaid
    Program staff for review and analysis.
    Conducts meetings with Agency personnel, stakeholders, and process owners.
    (Future) Participates in DASH (Replacement MMIS) project meetings, as needed,
    where reference administration expertise is required.
    Serves as an agency subject matter expert (SME) for medical coding methodologies,
    Medicaid policy, and related topics.
    Research business rules, requirements, and models to complete initial analysis and
    recommendations.
    Maintains business rules, requirements, and models in a repository.
    Collaborates with team to ensure process documentation is complete, owner and
    stakeholder, as needed, training content is complete and routinely updated.
    May serve as a back-up to other roles within the bureau to support claim escalations
    research, once the person has demonstrated full proficiency in the job functions
    required for their new role
    Other project-related duties, as assigned or required
    REQUIRED SKILLS (RANK IN ORDER OF IMPORTANCE):
    3+ years' experience in healthcare
    Strong knowledge of ICD/CPT/HCPCS
    translation and coding methodologies
    3+ years extensive knowledge of
    anatomy, physiology, pharmacology,
    and medical terminology
    3+ years of strong knowledge of
    formal business process
    documentation
    PREFERRED SKILLS (RANK IN ORDER OF
    IMPORTANCE):
    3+ years' experience healthcare
    hospital, office and clinic setting
    Knowledge of Microsoft Office
    (Word, Excel, PowerPoint, Optum
    Encoder and other medical coding software programs)
    Other: preference for resources that
    are local to SC, NC, or GA. Resources
    can reside anywhere in the US but
    must be willing to travel onsite to
    Columbia, SC within notice from
    management at the resources
    expense.
    REQUIRED EDUCATION:
    Bachelor's degree in healthcare related field. An equivalent combination of experience and
    education may be considered with prior
    SCDHHS hiring team review and approval
    REQUIRED CERTIFICATIONS:
    Currently credentialed as CPC (Certified
    Professional Coder) or as CCS (Certified
    Coding Specialist).
    The interviews will be conducted by a team either in-person or via video conferencing.

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