Business Consultant - Clinical Products

CareFirst, Inc.; United States; Remote; USD 80,000 - 100,000; Full time

Job summary

A leading healthcare firm is seeking a Business Consultant - Clinical Products for a remote position. The successful candidate will provide expertise in Utilization Management processes, oversee system setup, and improve business operations. Required qualifications include a Bachelor's degree or relevant experience, along with 5 years in healthcare consulting or related fields. Strong knowledge of medical coding systems is essential.

Qualifications

• 5 years of experience in business development or related healthcare consulting.
• Expert-level knowledge of Utilization Management processes and regulatory requirements.
• Proven ability to manage system configuration specialists.

Responsibilities

• Provide expertise in Utilization Management processes and optimize business processes.
• Oversee UM system setup and guide configuration specialists.
• Build relationships across the organization to improve task execution.

Skills

Utilization Management processes

Business development

Healthcare consulting

Medical coding systems

Education

Bachelor's Degree or equivalent experience

Job description

A company is looking for a Business Consultant - Clinical Products (Remote).

Key Responsibilities

• Provide expertise in Utilization Management (UM) processes and optimize business processes
• Oversee UM system setup and guide configuration specialists to align with clinical policies
• Build relationships across the organization to identify synergies and improve task execution

Required Qualifications

• Bachelor's Degree or 4 additional years of relevant work experience in lieu of a degree
• 5 years of experience in business development, operational technology support, or related healthcare consulting
• Expert-level knowledge of UM processes and applicable regulatory requirements
• In-depth understanding of medical coding systems and code maintenance cycles
• Proven ability to manage system configuration specialists for clinical/UM products