Senior Manager/ Associate Director - Technology Consulting(Government Claims)
Job title: Senior Manager/ Associate Director - Technology Consulting(Government Claims) in Chicago, IL at Tiger Analytics
Company: Tiger Analytics
Job description: Job Description:Tiger Analytics is pioneering what AI and analytics can do to solve some of the toughest problems faced by organizations globally. We develop bespoke solutions powered by data and technology for several Fortune 100 companies. We have offices in multiple cities across the US, UK, India, and Singapore, and a substantial remote global workforce.If you are passionate about working on business problems that can be solved using structured and unstructured data on a large scale, Tiger Analytics would like to talk to you. Now hiring for multiple opportunities in Technology Consulting and Solution Delivery.Responsibilities
- Work closely with clients and business SMEs to analyze pain points in the Medicare and Medicaid processes (with greater focus on claims management) and provide detailed information on business procedures, industry regulations, and user needs.
- Evaluate and recommend AI, analytics, software, and engineering use cases to address client challenges with regards to complex business logics and user workflows.
- Provide critical insights and guidance to project teams, ensuring that the solution accurately reflects the complexities and nuances of Medicare and Medicaid domain (specifically focused on claims management), when developing products, systems, or processes.
- Partner with analytics and technology consulting teams to share insights on key processes, personas, and tools, ensuring alignment on effective solutions.
- Assess project deliverables, design documents, and test cases to ensure they align with domain knowledge and industry best practices.
- Educate project teams on Medicare/Medicaid domain-specific concepts, jargon, and industry standards. Support the development of capability assets (including documents, demos) for the Medicare & Medicaid LOB within Tiger's Consulting, DS, and Engineering Practice.
- 12-15 years of deep domain consulting experience with strong Data Engineering background.
- Extensive understanding of US healthcare and Medicare and Medicaid industry and its specific regulations.
- Excellent analytical skills to identify potential issues and propose solutions by effectively conveying technical information to diverse teams.
- Good understanding of plan offerings (e.g., Medicare Advantage, FFS etc.), coverage, and eligibility for Medicare and Medicaid programs.
- Familiarity with HCPCS, CPT, ICD codes, taxonomy codes, state billing guidelines, and fee schedules.
- Knowledge of CMS guidelines, ACA, and HIPAA regulations for compliance and data security.
- Excellent problem solving and critical thinking skills with diligence.
- Experience with managing stakeholder expectations to ensure effective communication and program success.
- Ability to stay updated on industry trends and emerging technologies.
- Masters/Bachelor of Science/Engineering, MBA preferred.
- Healthcare certifications preferred.