Business Consultant

Business Consultant at HealthEdge Software Inc in Boise, Idaho, United States Job Description 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'rechanging the industry narrative, providing a moreholistic approachto 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 areidentifiedand addressed upstream, and all aspects of claims operations are centralized for comprehensive business intelligence. The complete suite of solutions fromHealthEdgedelivers 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 To view full details and how to apply, please login or create a Job Seeker account