Senior Claims Solution Consultant
Location:
Norwalk , Connecticut
Posted:
August 11, 2016
Reference:
16004598-en-us

Senior Claims Solution Consultant

Location: Norwalk, CT or U.S. Remote

 

The Senior Claims Solution Consultant (Sr. 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 software implementation.  They are also responsible for supporting their clients during maintenance periods which may require researching issues, analyzing software behavior and remediating defects.
 
The Senior Claims Solution Consultant must be an active consultative client facing subject matter expert within the assigned team structure to ensure quality client deliveries within targeted timeframes based upon work effort.  This resource is frequently responsible for taking lead with confidence and driving client facing initiatives through conclusion.  They also act as an internal mentor supporting less experienced team members through their assigned work effort.   The Senior CSC may be required to work independently effectively and without management oversight.

 

  • Effectively work as a ClaimsXten rules development subject matter expert on client implementations of the software. This will require working consultatively with the client and documenting granular requirements for signature
  • Address all assigned client issues & requests that are generated through the McKesson Services Support Center typically during production support working with McKesson Clinical,  Product and or McKesson Development Team(s).
  • Effectively participate or lead internal or external ClaimsXten Service Delivery Team meetings and initiatives. Conduct training as needed. Act as a mentor to less experience team members through their assigned tasks
  • Provide forecasting, supply requested metrics and attend or potentially lead team meetings.  Work with the Engagement Manager to determine internal project milestones to drive client deliveries.
  • 10 - 15% travel

 

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.



Qualifications

 

Minimum Requirements


4+ years of experience in health care claim



  • Critical Skills
  •  
  • Customer’s Business
    • High level of expertise in payor environments and claims management
    • Granular understanding of different customer segments (national, strategic and/or specialized business) 
    • High level understanding of claim architecture, infrastructure, and multiple platforms
    • Discusses customer issues (pains and trends) confidently with customers
    • 2 – 5 years of medical claims experience within payor environment required.
    • SDLC exposure needed

    Clinical

    • High level of understanding of medical terminology, healthcare industry terminology and medical coding terminology
    • Must be able to articulate the clinical value of products and services provided to clients
       

    Communication

    • Confidently delivers presentations effectively to the customer
    • Confidently understand and articulate ClaimsXten rules development
    • Confidently conducts customer meetings/trainings efficiently and effectively
       

    Software Tools

    • High-level proficiency in the following software:
    • Word
    • PowerPoint
    • Excel
    • Visio

    Additional Knowledge & Skills

    • Comprehensive understanding of industry issues & ability to translate them into complex or creative solutions
    • In-depth knowledge of supported systems & other systems across multiple areas
    • Expertise on product/application functionality
    • Expertise in healthcare issues that are relevant to the business unit

    Education

    • Bachelor’s Degree in computer science, healthcare related field, or equivalent business experience



    Certifications/Licensure


    Physical Requirements
    General Office Demands


    Benefits & Company Statement
    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.

    A little about us:
    McKesson is in business for better health.

    Know someone who would be interested in this job? Share it with your network.