Business Solution Manager

🕒 Agosto 5

🇺🇸 Estados Unidos – Remoto (EUA)

⏰ Tempo Integral

🟡 Pleno

🟠 Sênior

👔 Gerente

🦅 Patrocina Visto H1B

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👻 Score fantasma 11%

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🗣️🇺🇸🇬🇧 Inglês obrigatório

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Logo of Abacus Insights

Abacus Insights

51 - 200 funcionários

🏥 Saúde

💼 Consultoria

📦 Logística

Healthcare • Consulting • Logistics

A Abacus Insights é uma líder em soluções de dados para planos de saúde que capacita os pagadores de saúde, fornecendo dados utilizáveis e interoperáveis. A empresa oferece um conjunto abrangente de soluções de dados projetadas para atender a complexos mandatos governamentais e melhorar a prontidão dos pagadores. A plataforma da Abacus Insights é capaz de consolidar e normalizar diversas fontes de dados em registros de pacientes completos, garantindo a precisão dos dados e facilitando atualizações rápidas. Suas soluções suportam múltiplos casos de uso, incluindo ajuste de riscos, troca de dados clínicos, gestão de custos e relatórios de desempenho. Com foco em tecnologia e saúde, a Abacus Insights ajuda os pagadores a gerenciar custos e melhorar a experiência dos membros através de capacidades aprimoradas de gerenciamento de dados.

Descrição

• Lead discovery sessions with client subject matter experts to understand business context, pain points, expected outcomes, and success criteria • Translate use cases into clear, testable requirements with success criteria and non-functional requirements • Document requirements and translate them into source-to-target data flows, transformation logic, and business rules • Determine dataset grain and structure based on business context and trace downstream impacts • Map dependencies across workstreams, reports, and client use cases • Design reusable patterns across clients, states, and use cases • Write and execute SQL to analyze data, test assumptions, and prototype • Drive requirements-gathering and clarification conversations with clients • Represent client intent throughout engagements and remain an active delivery contact • Translate between business and technical audiences • Connect clients with internal delivery teams and provide context, business rules, and logic • Serve as the client subject-matter expert for Solution Architects, Product, QA, Account Management, and Program Management • Assess cross-workstream effects and flag potential rework

🎯 Requisitos

• Bachelor's degree, or equivalent relevant experience • 3+ years working in the US healthcare domain and with healthcare data • Payer experience required, including direct experience with or for a US health plan covering Medicare, Medicaid, or Commercial lines • Working command of membership/enrollment, provider, claims, and authorization payer concepts • Required ability to write and execute SQL to explore, probe, and prototype against data • Experience eliciting and authoring business requirements in complex, data-driven environments • Confident client-facing communication and ability to drive requirements conversations • Ability to operate with ambiguity and reprioritize across large, multi-workstream engagements • Demonstrated systems thinking and experience designing for reuse and scale across states, clients, or use cases • Familiarity with Databricks or Snowflake is desirable • Familiarity with HEDIS, Stars quality reporting, risk adjustment, payment integrity, value-based care analytics, provider data management, or CMS interoperability is desirable • Working knowledge of data modeling concepts is desirable • Familiarity with Medicaid data or PBM platforms is desirable

🏖️ Benefícios

• Unlimited paid time off – recharge when you need it • Work from anywhere – flexibility to fit your life • Comprehensive health coverage – multiple plan options to choose from • Equity for every employee – share in our success • Growth-focused environment – your development matters here • Home office setup allowance – one-time support to get you started • Monthly cell phone allowance – stay connected with ease • Eligibility for performance bonuses

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