Job Summary
The SDM-IOA Delivery role requires a seasoned professional with 7 to 9 years of experience in technical and domain skills. The candidate will work in a hybrid model with night shifts focusing on QNXt SQL and Facets - Claims and Benefits. The role involves managing claims provider and payer domains ensuring seamless delivery and integration.
Responsibilities
Manage and oversee the delivery of solutions using QNXt SQL and Facets technologies to ensure efficient operations in claims and benefits processing.Collaborate with cross-functional teams to align technical solutions with business objectives enhancing provider and payer domain functionalities.Implement strategies to optimize claims processing workflows reducing turnaround time and improving accuracy.Analyze and interpret complex data sets using SQL to support decision-making processes and drive business improvements.Develop and maintain documentation for system processes and configurations to ensure clarity and continuity in operations.Coordinate with stakeholders to gather requirements and translate them into actionable technical specifications.Monitor system performance and troubleshoot issues to minimize disruptions and maintain high service levels.Facilitate training sessions for team members to enhance their understanding of FacetsClaims and Benefits functionalities.Conduct regular audits of system processes to ensure compliance with industry standards and regulations.Provide insights and recommendations for system enhancements based on emerging trends and technologies in the healthcare domain.Support the integration of new technologies and methodologies to improve overall system efficiency and user experience.Engage in continuous learning to stay updated with the latest advancements in claims provider and payer domains.Drive initiatives that contribute to the companys purpose and positively impact society by improving healthcare delivery systems.
Qualifications
Possess strong expertise in QNXt SQL and FacetsClaims and Benefits demonstrating a deep understanding of these technologies.Have extensive experience in the claims provider and payer domains showcasing the ability to manage complex healthcare processes.Demonstrate excellent analytical skills to interpret data and provide actionable insights for business improvements.Exhibit strong communication skills to effectively collaborate with cross-functional teams and stakeholders.Show proficiency in troubleshooting and resolving technical issues to maintain high system performance.Display a proactive approach to learning and adapting to new technologies and industry trends.Hold a bachelors degree in a relevant field with certifications in healthcare IT systems being a plus.
Certifications Required
Certified Facets Professional SQL Certification
