Clinical Analyst

Job not on LinkedIn

🔥 13 hours ago

🇺🇸 United States – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

🧐 Analyst

👻 Ghost score 10%

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Lyric - Clarity in motion.

WebsiteLinkedInAll Job Openings

201 - 500 employees

🏥 Healthcare

💼 Consulting

📦 Logistics

Healthcare • Consulting • Logistics

Lyric is a leading healthcare technology company focused on payment integrity and accuracy solutions. With over 30 years of experience, Lyric aims to simplify the business of care by leveraging machine learning and predictive analytics to empower health plan payers. The company provides a range of solutions, including Lyric 42 Platform, Pre-Pay Editing, Diagnostics Module, Coordination of Benefits, Concept Libraries, and LyricIQ, which combines AI-powered payment accuracy services. Additionally, Lyric focuses on transparency and responsibility in technology development, ensuring enhanced payment accuracy, administrative efficiencies, and reduced provider abrasion. As a trusted partner in the healthcare industry, Lyric continues to deliver cutting-edge technologies at the crossroads of healthcare and fintech, supporting health plans and providers in the shift to value-based care.

📋 Description

• Apply claims analytics to identify opportunities for coverage criteria and claim edit development • Identify and critically evaluate medical literature as part of evidence-based policy development • Draft, review, and maintain coverage criteria based on age, clinical presentation, risk factors, and other characteristics • Provide written and oral presentations to peers and leadership to obtain consensus on proposed criteria • Recommend and program rules/logic for denial of claims based on written policy criteria • Enter clinical content into internal tooling and databases • Provide clinical content support to customers in collaboration with Customer Operations as needed

🎯 Requirements

• Applicants must already be legally authorized to work in the U.S. • Visa sponsorship/sponsorship assumption and other immigration support are not available • Bachelor’s degree in biology, nursing, health sciences, or a related field • 5 years’ experience in direct patient care, clinical research, utilization management, payment integrity, revenue cycle management, clinical product development/program management, market access/medical science liaison, or medical writing • Demonstrated technological proficiency with software applications including MS Word, MS Excel, and JIRA or Monday.com or other project management software • Excellent verbal and written communication skills • Strong analytical skills, including analysis of qualitative and quantitative information • Comfort with basic formulas, sorting, filtering, and pivot tables in Excel and similar applications, or willingness to learn

🏖️ Benefits

• Equal Opportunity Employer • Inclusive environment • Collaborative success • Base salary compensation (specific amount not provided)

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