McKesson is in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. McKesson Health Solutions delivers industry-leading clinical evidence and expert technology to help payers and providers collaborate for better healthcare outcomes at lower costs. Our solutions reduce unnecessary healthcare utilization while improving outcomes; operationalize complex volume- and value-based payment models; and optimize billing communication between providers, patients and payers. Our solutions are in more than four out of five payers in the country; more than 3,900 hospitals and facilities use our InterQual® evidence-based decision support criteria; and our RelayHealth® financial solutions are used to automate 1.9 billion financial transactions each year.
We understand the importance of a system that works together. Your expertise, drive and passion can help us carry out our mission to improve lives and advance healthcare.
Join our team of leaders to begin a rewarding career.
Claims Solution Consultant Position Description
The Claims Solution Consultant (CSC) is responsible for
understanding their assigned clients claim systems and payment policies so they
may document requirements for implementing services and rule engine components
either during the initial and/or subsequent phase of implementation. They
are also responsible for supporting their clients during maintenance periods
which may require researching issues, analyzing software behavior and
remediating defects. The
Claims Solution Consultant must be an active consultative client facing
participant within the assigned team structure to ensure quality client
deliveries within targeted timeframes based upon work effort and
- Effectively work as a
ClaimsXten rules development subject matter expert on client
implementations. This will require working in a consultative manner with
the client and documenting granular requirements for signature.
- Address all assigned client
issues & requests that are generated through the McKesson
Services Support Center.
- Effectively participate on
internal or external ClaimsXten Service Delivery Team meetings and
initiatives. Conduct training as needed.
- Provide forecasting, supply
requested metrics and attend or potentially lead team meetings.
- 4+ years experience in business analysis, requirements definition, building systems solutions and deployment of business requirements to information systems.
Additional Knowledge & Skills
- 3+years of experience in health
care combining first hand payor and consulting experience
- Medical claims experience
within payor environment ideal
- SDLC exposure needed.
- Understands payer environments
and claims management
- High level understanding of
different customer segments (national, strategic and/or specialized
- High level understanding of
claim architecture, infrastructure, and multiple platforms
- Discusses customer issues
(pains and trends) confidently with customers
- Understands medical
terminology, healthcare industry terminology and medical coding
- Must be able to articulate the
clinical value of products and services provided to clients
- Delivers presentations
effectively to the customer
- Able to understand and
articulate ClaimsXten rules development
- Conducts customer
meetings/trainings efficiently and effectively
- Travel 10% to 15%
- High-level proficiency in the
- Understanding of industry issues & ability to translate them into moderately complex solutions
-In-depth knowledge of supported systems within own area of expertise
-Understanding of implications of business requirements on the application(s) & ability to identify potential impacts to other product/ application areas
Physical RequirementsBenefits & Company Statement
- 4-year degree in computer science or related field or equivalent experience
McKesson believes superior performance – individual and team – that helps us drive innovations and solutions to promote better health should be recognized and rewarded. We provide a competitive compensation program to attract, retain and motivate a high-performance workforce, and it’s flexible enough to meet the different needs of our diverse employee population.
We are in the business of better health and we touch the lives of patients in virtually every aspect of healthcare. We partner with payers, hospitals, physician offices, pharmacies, pharmaceutical companies and others across the spectrum of care to build healthier organizations that deliver better care to patients in every setting.
But we can’t do it without you. Every single McKesson employee contributes to our mission—whatever your title, whatever your role, you act as a catalyst in a chain of events that helps millions of people all over the globe. Talented, compassionate people are the future of our company—and of healthcare. At McKesson, you’ll collaborate on the products and solutions that help us carry out our mission to improve lives and advance healthcare. Working here is your opportunity to shape an industry that’s vital to us all.
McKesson is an equal opportunity and affirmative action employer – minorities/females/veterans/persons with disabilities.
Qualified applicants will not be disqualified from consideration for employment based upon criminal history.Agency Statement
No agencies please.