- Analyze and document current state processes, workflows, and pain points related to Health Insurance/Dental Payor processes.
- Develop business cases, requirements documents, and functional specifications for Health Insurance/Dental Payor implementations.
- Conduct user acceptance testing (UAT) and gather feedback from end-users to ensure alignment with business needs.
- Collaborate with project managers, architects, and other team members to ensure successful delivery of Health Insurance/Dental Payor platform projects on time and within budget.
- Perform project tasks independently and may lead workstreams, directing the efforts of others.
- Participate in and/or lead the development of deliverable content that meets the needs of the client and contract.
- Review deliverables for accuracy and quality.
- Use your prior experience to anticipate client needs and formulate solutions to client issues.
- Contributes to proposal development.
- Collaborate with stakeholders to understand business objectives, processes, and requirements related to document management.
- Domain knowledge of Claims Administration platforms
- Minimum 5+ years prior experience working for a Health Insurance /Dental Insurance provider
- Lead small to medium-size teams to deliver management consulting projects for global clients.
- Health Industry expertise with understanding of dental healthcare ecosystem on how health insurance is offered, administered, serviced, and managed in different categories; and on how care delivery is managed across different settings and different channels.
- Subject matter expertise in dental payer, plan sponsor/employers, plan design and/or provider functional value chain components
- Performing market research, creating user journeys, service blueprint, PRDs, other documents, UAT support & demos to clients.
- Experience implementing medical standards (HIPAA, HL7, FHIR, Hierarchical condition category [HCC] coding)
- Experience with HEDIS measurements, STARS and CAHPS, NCQA used throughout the Healthcare industry (Optional).
- Execute a transformational change plan aligned with clients business strategy. Engage stakeholders in the change journey and build commitment for change.
- Knowledge of Clinical process assessment/redesign, Clinical cost reduction strategy, Acute/chronic care management/ Wellness and disease management programs
- Hands on experience on Intelligent utilization management, Connected care and digital health products, Clinical value use cases development, benefit assessment and implementation, Healthcare data sets, EMR/EHR and exposure to analytics tools and techniques.
- Successful track record using Lean/Agile methodology.
- Proven ability in handling multiple large projects and responding quickly to changing situations in complex environments.
- Excellent oral and written communication skills.
- Initiative to set and achieve performance goals.
- Good analytic and negotiation skills.
- Responsive to internal and external client needs.
- Strong team player
- Ability to clearly communicate verbally and/or in writing both internally and externally.
- Must be legally authorized to work in the United States without the need for employer sponsorship, now or at any time in the future.
- Ability to travel %, on average, based on client needs and requirements.
- Proficient with Microsoft Office programs.
- Ability to cope with job pressures in a constantly changing environment.
- Must be detail oriented and a self-starter with strong organizational abilities.
- Ability to coordinate and prioritize required.
- Flexibility, accuracy, initiative, and the ability to work with minimum supervision.
- Discretion and confidentiality required.
- Reliable, predictable attendance within client service hours for the performance of this position.
- AZ adjusters license required.
- AIC, CPCU, or ARM preferred.
- SAFe Product Owner/Product Manager certification
- SAFe Lean Portfolio Management certification
- Medical/Dental/Vision/Life Insurance
- Long-term/Short-term Disability
- Health and Dependent Care Reimbursement Accounts
- Insurance (Accident, Critical Illness , Hospital Indemnity, Legal)
- 401(k) plan and contributions dependent on salary level
- Paid holidays plus Paid Time Off
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Senior Consultant- Healthcare Insurance/Dental Payor - Richardson, United States - Infosys Consulting
Description
Senior Consultant Health Insurance/Dental Payor
About the role
Are you a strong analyst that has deep domain expertise in Health Insurance/Dental Payor from working in this industry who loves to be on the cutting edge, solving problems though innovative technology solutions? Are you passionate about innovative application development efforts working for a top tier IT consulting firm focused on creating a new all-digital offering for Health Insurance/Dental Payor clients? Do you have experience in customer strategy, operational process improvements, and platform development? By joining our team, you will play a vital role in making an impact for our clients and the people they serve through our growth strategy, enhanced user experiences, and engagement through the entire lifecycle of customers' interactions within the Health Insurance/Dental Payor industry.
Work you'll do
Basic Qualifications
Preferred Qualifications:
Certificates, Licenses, Registrations
About Us:
Infosys Consulting is a global management consulting firm helping some of the worlds most recognizable brands transform and innovate. Our consultants are industry experts that lead complex change agendas driven by disruptive technology. With offices in 20 countries and backed by the power of the global Infosys brand, our teams help the C-suite navigate todays digital landscape to win market share and create shareholder value for lasting competitive advantage. To see our ideas in action, or to join a new type of consulting firm, visit us at
Along with competitive pay, as a full-time Infosys employee you are also eligible for the following benefits:
Infosys is an equal opportunity employer, and all qualified applicants will receive consideration without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, protected veteran status, spouse of protected veteran, or disability.
