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Associate Medical Director, Clinical Informatics

Pune, Maharashtra
Posted: 16 March, 2019

Job Descriptoin

Associate Medical Director, Clinical Informatics

What You’ll Be Doing:

  • Review and ownership of Evolent’s clinical content, including but not limited to rules algorithms, care management programs, predictive models, patient stratifications, patient survey questionnaires, etc.
  • Understanding of US healthcare insurance business – Value based care, insurance, ACOs, EMR systems, etc.
  • Surveillance and proactive updates of Evolent content from US medical society best practice guidelines (i.e., USPSTF, ADA, ACOG, ACC, etc) relating to Evolent 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/documentation and 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):

  • Medical Doctor Degree with 1-3 years of direct patient care experience or Public Health/Preventive Medicine related experience
  • 1-3 years experience with US healthcare practice and business
  • 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

Evolent Health - 14 days ago

How to Apply?