09/05 Neha Khaladkar
Associate Manager at Hexagon Executive Search

Views:260 Applications:11 Rec. Actions:Recruiter Actions:1

Clinical Specialist - Hospital - GNM (3-10 yrs)

Pune Job Code: 6311

Description

Clinical Specialist

What You- ll Be Doing:

- Review clinical accuracy and validity of clinical rules algorithms.

- Surveillance of US medical society best practice guidelines (i.e., USPSTF, ADA, ACOG, ACC, etc) relating to clinical quality algorithms.

- Provide clinical context for maintenance and creation of code sets relating to US clinical quality measures (ICD10, CPT, LOINC, etc).

- Researching and reviewing appropriate clinical algorithms for various business & clinical use cases to support rules construction.

- Assist with quality assurance related to rule engine algorithms including performance and reporting to assess and quantify the impact of upstream data issues.

- Support Clinical Informatics team with creation/documentationand maintenance of technical specifications for algorithms that describe a patient's clinical data and experience.

- Surveillance and assessment of industry standard quality programs and metrics.

The Experience You- ll Need (Required):

- Nursing Degree with 1-3 years of direct patient care experience or Public Health related experience

- Experience with US medical claims coding systems - ICD10, CPT, Revenue Codes, Place of Service Codes, etc.

- Excellent attention to detail and dedication to team-based production of high quality deliverables

- Superb oral and written communication, organizational, and analytical skills

- Experience with MS Office product suite, especially with Excel, Word, PowerPoint

Finishing Touches (Preferred) :

- Experience with clinical quality measures (e.g., HEDIS, PQRS,CMS etc.)

- Experience with additional US Medical claims coding systems - SNOMED codes, LOINC codes, etc.

- Experience with US Rx claims coding system - RxNorm, GPI codes.

- Strong understanding in researching data issues; excellent analytical and QA skills; and ability to take large sets of data and find anomalies and troubleshoot data issues to ensure data integrity.

- Experience in analyzing, defining and documenting business processes and rules.

This job opening was posted long time back. It may not be active. Nor was it removed by the recruiter. Please use your discretion.

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