Overview
Overview:
The Business Consultant leads and mentors the Service Delivery team in all Tier 1 (Basic) and Tier 2 (Intermediate) consulting initiatives. The position provides in-depth and comprehensive subject matter expertise related to Source products (from basic to advanced features/functionality), payment methodologies/policies (Medicare, Medicaid, and commercial), payment integrity, and healthcare plan operations (e. g. , claim life cycle/workflow, network contracting, payment/policy configuration, provider relations, medical management, medical economics, audit, compliance) related to implementation/consulting engagements, strategic user adoption initiatives, and ongoing client support.
The Product:
With Source, we're changing the industry narrative, providing a more holistic approach to payment integrity that focuses on comprehensive reimbursement, agile editing, and integrated analytics. Our interoperable, cloud-based solution is modular to meet a health plan's needs today and extensible to grow with their organization over time-bringing disparate parts of a payer's organization together for improved accuracy and insights. The Source platform offers the ability for clients to unlock transformation at the reimbursement, payment integrity, and enterprise level. Our Reimbursement Transformation features Medicare and Medicaid content coupled with flexible contract configuration capabilities for Commercial lines of business. Payment Integrity Transformation includes rich editing libraries with history-based capabilities, easy development of customized edits, and improved transparency to reduce vendor dependency and increase control. As a complete solution, clients can achieve Enterprise Transformation, where root-cause issues are identified and addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite of solutions from HealthEdge delivers a digital foundation for payers specifically designed to fuel a digital transformation, reduce costs, and improve both clinical outcomes and the member experience.
Who you are:
*Creative entrepreneur. * You have a constant drive to make things better; you question the status quo and approachcommon challengeswith creativity and constructive criticism. You have skills toclearly and convincingly share ideasin a way that adapts to your audience, regardless of function, level, orexpertise.
Critical, big-picture thinker . You have a constant thirst for knowledge and the ability to credibly share it with others, whether internally or externally. You are analytical, evaluating logic-based details while always considering and problem solving for the sake of the big picture.
*Self-starter. * You are proactive, self-motivated, and able to push work, start initiatives, and provide ideas independently in a team environment.
*Team player & coach. * You can foster professional and personal respect from others and find success in a team setting. While highly collaborative, you have natural management skills and know how to grow and develop people.
*Adaptable multi-tasker. * You are highly organized and flexible. You know how to manage expectations and are able to thrive in fast-paced, constantly changing environments and successfully adapt to a variety of tasks.
What you will do:
Education and Consulting (implementation/consulting engagements, strategic user adoption initiatives, and on-going client support)
Provide the highest level of product education (from basic to advanced features/functionality to Source end-users
Provide in-depth and comprehensive subject matterexpertiserelated to:
Medicare, Medicaid, and commercial payment methodologies/policies
Payment integrity
Healthcare plan operations (e. g. , claim adjudication life cycle/workflows, network contracting, payment/policy related configuration, provider relations, medical management, medical economics, audit, compliance)
Conduct collaborative scoping sessions toidentifyclient needs andappropriate solutions
Actively manage and/orparticipatein the development, maintenance, and execution of client facing education services
Enhancement/Issue Escalation
Manage issues, questions, inquiries of Tier 1 and 2escalation
Serve as escalation point for critical client needs aswarranted.
Lead diagnosis and resolution of escalated and more involved/complex client problems and issues.
Act as a liaison between clients and internal support staff (research, development, and product teams) to assureaccurateproblem interpretation and resolution.
Capture andsolicitissues/feedback from clients and internal stakeholders and document issues and client impacts.
Partner withappropriate Source Teams(BA, PM, Development, Account Management, Sales/Business Development, Product, Content, and Service Delivery) to manage problem framing,diagnosisand resolution.
Conduct/participatein root cause analysis toidentifyand deliver warranted service improvements.
Maintain demeanor as a calming influence during pressure situations, mixing in the correct degree of professional assertiveness without becoming aggressive.
Maintain communication with customers during the problem resolution process,utilizingsuperior customer service skills.
Capability/Tool Development/Maintenance
Leverage capabilities and tools (knowledge libraries, workflow, issue identification and documentation, function processes).
Lead capability and tool development underdirectionof Service Delivery Leadership.
Staff/Team Management/Supervision
Mentor and provide oversight for Tier 1 and 2 Service Delivery staff
Take direction from and collaborate with Service Delivery Leadership to continually review and enhance performance and strategy.
Whatyoubring:
Bachelor's degree in a business, health services administration, mathematics,scienceor related field, and/or equivalent work experiencerequired.
AHIP, HFMA, AAPC, and/or AHIMA certification preferred.
5+ years training, education, and/or consulting experience preferred.
Practical understanding of the healthcare system with regards to Medicare, Medicaid, managed care, and commercial payment methodologies, payment integrity, and health plan operations (e. g. , claim life cycle/workflows, network contracting, payment/policy related configuration, provider relations, medical management, medical economics, audit, compliance).
Experience with interpretation/translation of complex health-plan in-network and out-of-network provider rate and/or claim editing provisions.
Experience with config.
US - VT - VT - Springfield
January 23, 2025
Vivian is looking for Travel Telemetry RNs in Springfield, Vermont paying up to $2,336/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your reputation...
Fusion Medical Staffing Nursing
US - VT - VT - Burlington
January 23, 2025
Fusion Medical Staffing-Nursing is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Burlington, Vermont. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/24/2025 • Duration: 20 weeks • 36 hours per week • Shift: 12 hours •...
US - VT - VT - Berlin
January 23, 2025
Vivian is looking for Travel MRI Technologist Allied Health Professionals in Berlin, Vermont paying up to $3,687/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a...
US - VT - VT - Swanton (Town)
January 20, 2025
Vivian is looking for Travel MRI Technologist Allied Health Professionals in Swanton (Town), Vermont paying up to $2,669-3,075/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: •...
US - VT - VT - Middlebury
January 22, 2025
Cross Country Nurses is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Middlebury, Vermont. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/17/2025 • Duration: 20 weeks • 36 hours per week • Shift: 12 hours, nights • Employment...
US - VT - VT - Middlebury
January 23, 2025
Triage Staffing is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Middlebury, Vermont. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/17/2025 • Duration: 20 weeks • 36 hours per week • Shift: 12 hours, nights • Employment...
US - VT - VT - Burlington
January 23, 2025
Vivian is looking for Travel Registered Respiratory Therapist Allied Health Professionals in Burlington, Vermont paying up to $2,497/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get...
US - VT - VT - Brattleboro
January 23, 2025
Vivian is looking for Travel PCU - Progressive Care Unit RNs in Brattleboro, Vermont paying up to $2,308/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile -...
US - VT - VT - Springfield
January 23, 2025
Vivian is looking for Travel Physical Therapist Therapys in Springfield, Vermont paying up to $2,460/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build...
US - VT - VT - Newport
January 23, 2025
Vivian is looking for Travel Occupational Therapist Therapys in Newport, Vermont paying up to $2,290/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build...
US - VT - VT - Saint Albans City
January 23, 2025
Come practice in Saint Albans in northwestern Vermont on the shores of Lake Champlain, nestled between the Northern Adirondacks and Green Mountains. Discover this northwest Vermont paradise, experience four seasons, and feel the comfort of the charming community of St Albans. Proximity to Burlington...
US - VT - VT - Middlebury
January 23, 2025
Vivian is looking for Travel ED - Emergency Department RNs in Middlebury, Vermont paying up to $2,901/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build...
US - VT - VT - Saint Albans City
January 23, 2025
Come practice in Saint Albans in northwestern Vermont on the shores of Lake Champlain, nestled between the Northern Adirondacks and Green Mountains. Discover this northwest Vermont paradise, experience four seasons, and feel the comfort of the charming community of St Albans. Proximity to Burlington...
US - VT - VT - Middlebury
January 22, 2025
Cross Country Nurses is seeking a travel nurse RN Labor and Delivery for a travel nursing job in Middlebury, Vermont. & Requirements • Specialty: Labor and Delivery • Discipline: RN • Start Date: 02/24/2025 • Duration: 12 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type: Travel As...
US - VT - VT - Saint Albans
January 23, 2025
Supplemental Health Care is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Saint Albans, Vermont. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: ASAP • Duration: 13 weeks • 36 hours per week • Shift: 12 hours • Employment Type:...
US - VT - VT - Burlington
January 21, 2025
Vivian is looking for Travel Infusion RNs in Burlington, Vermont paying up to $2,765/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your reputation...
US - VT - VT - Springfield
January 23, 2025
Magnet Medical is seeking a travel CT Technologist for a travel job in Springfield, Vermont. & Requirements • Specialty: CT Technologist • Discipline: Allied Health Professional • Start Date: 01/27/2025 • Duration: 26 weeks • 36 hours per week • Shift: 12 hours, days • Employment Type: Travel A CT...
US - VT - VT - Rutland
January 23, 2025
Central VT SNF is looking for coverage for an ASAP start. Contact your CompHealth recruiter today to learn more! • ASAP start • 3 month assignment • Call to learn more! • We provide complimentary housing and travel • We arrange and cover costs for licensing and malpractice • We simplify the...
US - VT - VT - Newport
January 23, 2025
Vivian is looking for Travel Home Health RNs in Newport, Vermont paying up to $2,412/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your reputation...
US - VT - VT - Swanton (Town)
January 23, 2025
Vivian is looking for Travel Labor and Delivery RNs in Swanton (Town), Vermont paying up to $2,313/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build...
US - VT - VT - Windsor
January 22, 2025
Coast Medical Service is seeking a travel Physical Therapist for a travel job in Windsor, Vermont. & Requirements • Specialty: Physical Therapist • Discipline: Therapy • Start Date: 01/27/2025 • Duration: 13 weeks • 40 hours per week • Shift: 8 hours, days • Employment Type: Travel Coast Medical...
US - VT - VT - Springfield
January 23, 2025
Vivian is looking for Travel Med Surg / Telemetry RNs in Springfield, Vermont paying up to $2,474/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your...
US - VT - VT - Middlebury
January 22, 2025
GetMed Staffing, Inc. is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Middlebury, Vermont. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Start Date: 02/17/2025 • Duration: 20 weeks • 36 hours per week • Shift: 12 hours, nights •...
US - VT - VT - Middlebury
January 22, 2025
Go Healthcare is seeking a travel nurse RN ED - Emergency Department for a travel nursing job in Middlebury, Vermont. & Requirements • Specialty: ED - Emergency Department • Discipline: RN • Duration: 20 weeks • 36 hours per week • Shift: 12 hours, nights • Employment Type: Travel Go Healthcare Job...
US - VT - VT - Springfield
January 23, 2025
Vivian is looking for Travel Med Surg RNs in Springfield, Vermont paying up to $2,310/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your reputation...
US - VT - VT - Springfield
January 23, 2025
Central VTSNF is looking for coverage for an ASAP start. Contact your CompHealth recruiter today to learn more! • ASAP start • 3 month assignment • Call to learn more! • We provide complimentary housing and travel • We arrange and cover costs for licensing and malpractice • We simplify the...
US - VT - VT - Windsor
January 23, 2025
Vivian is looking for Travel LPN / LVN LPN / LVNs in Windsor, Vermont paying up to $1,617/week • At Vivian, we ensure your next step is a step forward. That's why we built a jobs marketplace that serves healthcare professionals first. It's easy to get started: • Create a profile - Build your...