Clinical Solutions Consultant (Remote)

Availity delivers revenue cycle and related business solutions for health care professionals who want to build healthy, thriving organizations. Availity has the powerful tools, actionable insights and expansive network reach that medical businesses need to get an edge in an industry constantly redefined by change.

At Availity, we're not just another Healthcare Technology company; we're pioneers reshaping the future of healthcare! With our headquarters in vibrant Jacksonville, FL, and an exciting office in Bangalore, India, along with an exceptional remote workforce across the United States, we're a global team united by a powerful mission.

We're on a mission to bring the focus back to what truly matters - patient care. As the leading healthcare engagement platform, we're the heartbeat of an industry that impacts millions. With over 2 million providers connected to health plans, and processing over 12 billion transactions annually, our influence is continually expanding.

Join our energetic, dynamic, and forward-thinking team where your ideas are celebrated, innovation is encouraged, and every contribution counts. We're transforming the healthcare landscape, solving communication challenges, and creating connections that empower the nation's premier healthcare ecosystem.

While clinical data holds enormous potential to drive more meaningful payer collaboration with providers, improve member outcomes and experience, and increase health plan efficiency and revenue, most health plans are increasingly challenged by the complexity and costs associated with acquiring clinical data. Today, clinical data is hard to reach, often residing within the four walls of provider system EHRs. Health plans must go through the laborious process of connecting directly to provider EHRs themselves, which is a tremendous burden given the multiple clinical data exchange protocols that can be used (e.g., REST, SFTP, SOAP, MLLP) and competing clinical data formats (e.g., Hl7v2, CCDA, FHIR). Availity is making big investments to address these challenges and accelerate growth of our clinical solutions. In the Clinical vertical of Availity, our mission is to make clinical data more universally accessible and actionable, resulting in automated workflows that drive a more effective, patient and provider experience. The Availity Clinical platform facilitates the exchange of clinical data between providers and payers as well as the activation of clinical data to drive broad-scale consumption and value realization for targeted payer use cases, including HEDIS and quality measurement, risk adjustment, population health analytics, claims adjudication, utilization management, and enterprise interoperability and FHIR enablement.

We are looking for a highly motivated member to join our clinical solutioning and consultation team, which sits within our clinical product vertical. The Clinical Connectivity Solutions Consultant will report directly to the Director of Clinical Solutioning and Consultation at Availity and will be expected to work in close partnership with our sales and account management teams as well as our product team to grow our clinical connectivity business. This individual will be charged with building out prescriptive connectivity proposals to support health plan customers both pre- and post-sale. They will have a firm understanding of clinical data standards, payer clinical use cases and data requirements to help inform connectivity proposals. They also will work closely with our clinical data partners to align areas of network strength to sales opportunities. This role requires a blend of technical acumen, clinical knowledge, and strong problem-solving skills. The ideal candidate will be passionate about helping payers successfully acquire and use clinical data and will embody a tenacious approach to winning deals and driving successful adoption of our connectivity solution, while also excelling in highly technical and strategic competencies.

Sponsorship, in any form, is not available for this position.

Location: Remote, US

Why you want to work on this team:

• Work on a team that is building out national clinical connectivity across the healthcare market and for a company that is one of the largest clearinghouses in the country
• Passionate about working with clients through a consultative approach
• Enjoy working and solving complex issues through deep analysis and research

To be qualified for this position you:

• Bachelor's or advanced degree in Business, Information Technology, healthcare, analytics or a related field.
• A minimum of 5 years of experience working at a health plan, an EHR, a health information technology company or in healthcare consulting
• Understanding of clinical data formats and standards: Hl7v2 (ADTs, ORUs), CCDA, FHIR and how these standards relate to clinical data exchange and connectivity use cases.
• A minimum of 3 years of experience with data analytics, utilizing SQL and experience in excel (Pivot Tables, Charts, Formulas)
• Experience working with provider data such as provider TINs and NPIs
• Excellent communication, negotiation, and presentation skills.
• Experience analyzing and presenting data.
• Experience managing complex multi-phase projects.
• Experience capturing and writing business and technical requirements to support product's network analytics dashboarding build-out

You will set yourself apart with:

• Strong understanding of clinical data standards (e.g., Hl7v2, C-CDA, FHIR) and clinical data exchange protocols
• Deep clinical data expertise along with very strong analysis skills
• Experience analyzing provider data
• Experience working for an EHR
• Experience utilizing Business Intelligence Tools to answer Business Questions (Power BI, Tableau, AWS Quicksight, etc.)

You will be:

• Creating prescriptive clinical data connectivity proposals and plans, presenting a cohesive narrative of the breadth of clinical connectivity Availity can provide to customers via our existing network of data connections and through our partners.
• Conducting network analyses by running health plan TIN and NPI analyses against our internal data bases to identify match rates.
• Conduct network analyses on our claim submissions via our clearinghouse and provider network.
• Collaborating with our clinical data trading partners (e.g., EHRs, HIEs, data aggregators) to acquire provider facilities/TINs that align to health plans or areas of geography as well as identify new health plan opportunities for the sales team to pursue.
• Creating prescriptive clinical data connectivity proposals and plans and collaborating with sales and account management to present a cohesive narrative of the breadth of clinical connectivity Availity can provide to customers via our existing network and through our partners.
• Offering prospects and customers consultation on how clinical data can successfully be applied to health plan use cases including HEDIS, risk adjustment, population health management, value-based care delivery, authorizations, and payment.
• Continuing to build-out and enhance connectivity plans over the course of the health plan contract.
• Offering support in connectivity technical solution design, functional expertise, and alignment to priority use cases.
• Working closely with our product team and problem solving across clinical connectivity partners to go after white space that lacks existing connections.
• Supporting account management team in building out ROI framework to ensure value recognition of our connectivity services.
• Delivering compelling presentations/demos of Availity connectivity solutions to potential clients, either independently or alongside the sales and account management teams.

Availity culture and benefits:

• Availity is a certified "Great Place to Work"! Culture is important to us and there are many ways for you to make your mark here!
• We have several Diversity & Inclusion teams, a Young Professionals Group, a She Can Code IT group for women in tech, and various ways to engage with fellow Availity associates.
• Availity is a culture of continuous learning. We have many resources and experts in our tech stack and in our industry that can help get you there too!
• Don't feel like wearing business attire? Cool, you can wear jeans - we are a casual place.
• We offer a competitive salary, bonus structure, generous HSA company contribution, healthcare, vision, dental benefits and a 401k match program that you can take advantage of on day one!
• We offer unlimited PTO for salaried associates + 9 paid holidays. Hourly associates start at 19 days of PTO and go up from there with all the same holiday benefits.
• Interested in wellness? We allow our associates to reimburse up to $250/year for gym memberships, participation in racing events, weight management programs, etc.
• Interested in furthering your education? We offer education reimbursement!
• Availity offers Paid Parental Leave for both moms and dads, both birth parents and adoptive parents.
• Want to work for an organization that gives back to the community? You're at the right place! Availity partners with various organizations, both locally and nationally, to raise awareness, funds and morale as our staff members volunteer their time and funds to engage the organizations campaign.

Next steps:

After you apply, you will receive text/email messages thanking you for applying and then you will continue to receive more text/email messages alerting you as to where you are in the recruitment process.

Interview process:

• Recruiter Recorded Video Pre-Screen
• Video Interview with Hiring Manager
• Video Peer Panel Interview
• Video Interview with Sales Team
• Final Video Interview with Chief Product Officer

Availity is an equal opportunity employer and makes decisions in employment matters without regard to race, religious creed, color, age, sex, sexual orientation, gender identity, gender expression, genetic information, national origin, religion, marital status, medical condition, disability, military service, pregnancy, childbirth and related medical conditions, or any other classification protected by federal, state, and local laws and ordinances.

Availity is a drug-free workplace. Candidates are required to pass a drug test before beginning employment.

NOTICE: Federal law requires all employers to verify the identity and employment eligibility of all persons hired to work in the United States. When required by state law or federal regulation, Availity uses I-9, Employment Eligibility Verification in conjunction with E-Verify to determine employment eligibility. Learn more about E-Verify at http://www.dhs.gov/e-verify.

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