Clinical Intelligence Specialist Job at ZeOmega
A Clinical Intelligence Specialist Job opportunity has emerged for qualified candidates to step into the role at ZeOmega. This position involves critical collaboration in reviewing medical coverage policies and ensuring the accuracy of converted documents. Interested applicants should apply before the deadline.
About ZeOmega:
ZeOmega is a healthcare technology company that specializes in providing innovative solutions for managing population health and care management. With a focus on improving health outcomes, ZeOmega leverages advanced analytics and clinical intelligence to support healthcare organizations in delivering quality care. The company is headquartered in the United States and is recognized for its commitment to enhancing healthcare delivery through technology.
Job Details:
- Position: Clinical Intelligence Specialist
Position Description:
In this Clinical Intelligence Specialist Job, you will work as a key collaborator in reviewing medical coverage policies converted by GenAI. The Clinical Intelligence Specialist will use their clinical experience to ensure that the converted documents match the medical coverage policies in PDF format. Post manual review, it is crucial to ensure that the converted medical policies are available in the questionnaire format within ClicBank, ZeOmega’s proprietary tool for content development and management.
Key Responsibilities:
- Ensure the converted documents match the source documents, identifying discrepancies and potential quality issues, and correcting them manually.
- Research and analyze as needed.
- Analyze the medical policies and identify documentation deficiencies.
- Assign codes for each answer option in the decision tree.
- Follow coding conventions and serve as a coding consultant.
- Act as a resource and subject matter expert for other coding staff.
- Assist lead or supervisor in orienting, training, and mentoring staff.
- Provide ongoing training to staff as needed.
- Handle special projects as requested.
Eligibility Criteria for Clinical Intelligence Specialist Job:
- Education: MBBS / MD / foreign medical graduate background, strong English writing skills, ability to read medical policies, and comfort with clinical documentation.
- Product Fit: Ability to explain policy rules to product managers, QA, engineers, and AI teams; identify ambiguity, versioning needs, auditability, and human-in-the-loop review points.
Required Skills:
- U.S. payer exposure, Medicare Advantage, Medicaid, Commercial payer, prior authorization, appeals, UM, medical necessity, HEDIS/Stars, risk adjustment, or clinical guidelines.
- Experience within a clinical setting and/or clinical research, critical thinking, time management, and medical coding.
- Computer Skills: Proficiency in Microsoft Office Suite – Word, Excel, PowerPoint, Visio, Teams, SharePoint, Outlook, and OneDrive.
The Clinical Intelligence Specialist Job at ZeOmega presents a significant opportunity for candidates with the right qualifications and experience. Interested individuals are encouraged to apply before the deadline to seize this opportunity in the healthcare technology sector.
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