R&D Clinical and Medical Coding Analyst - Remote

Thank you for your interest in working for our Company. Recruiting the right talent is crucial to our goals. On April 1, 2024, 3M Healthcare underwent a corporate spin-off leading to the creation of a new company named Solventum. We are still in the process of updating our Careers Page and applicant documents, which currently have 3M branding. Please bear with us. In the interim, our Privacy Policy here: https://www.solventum.com/en-us/home/legal/website-privacy-statement/applicant-privacy/ continues to apply to any personal information you submit, and the 3M-branded positions listed on our Careers Page are for Solventum positions. As it was with 3M, at Solventum all qualified applicants will receive consideration for employment without regard to their race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran. Job Description: R&D Clinical & Medical Coding Analyst - Remote 3M Health Care is now Solventum At Solventum, we enable better, smarter, safer healthcare to improve lives. As a new company with a long legacy of creating breakthrough solutions for our customers’ toughest challenges, we pioneer game-changing innovations at the intersection of health, material and data science that change patients' lives for the better while enabling healthcare professionals to perform at their best. Because people, and their wellbeing, are at the heart of every scientific advancement we pursue. We partner closely with the brightest minds in healthcare to ensure that every solution we create melds the latest technology with compassion and empathy. Because at Solventum, we never stop solving for you. The Impact You Will Make in this Role Solventum HIS is an international leader in designing and maintaining healthcare payment and quality outcome systems and advancing value-based care. We work closely with Medicare, Medicaid and commercial insurers on hospital, outpatient and population payment models and design quality outcome programs that promote patient safety and reduce avoidable costs. We also support more than ten countries on how they budget and pay for inpatient and outpatient care, and measure healthcare quality. Here, you will make an impact by:

• Providing subject matter expertise in the clinical content development, specification, documentation, validation, application, and maintenance of the Solventum outpatient public and proprietary groupers, code editors, and software including Tricare, Home Health, IOCE (Integrated Outpatient Code Editor), and EAPG (Enhanced Ambulatory Payment Grouper). These methodologies utilize healthcare data including diagnostic and procedural codes for determining payment and quality in healthcare.
• Contributing and coordinating with the research efforts related to the methodologies, provide input into the prioritization of the potential research enhancements.
• Work directly with the Chief Product Owner, Product Owners, and Research team to drive enhancements to the methodologies by translating the clinical hypotheses into clinical logic content specifications using existing coding systems; documenting and maintaining clear clinical specifications.
• Work directly and collaborate with the technical, quality, and clinical team members, integrating product concepts to implement and evaluate the clinical specification.
• Responsible for maintaining process documentation for the methodologies update using C&ER standards and methods.

Your Skills and Expertise To set you up for success in this role from day one, Solventum is looking for candidates who must have the following qualifications:

• Bachelor’s Degree AND 5 years’ experience in the healthcare industry in one or more of the following: outpatient medical coding and billing operations, outpatient prior authorization or denials management, outpatient healthcare claims and processing optimization, payor claims design and edit management, and outpatient healthcare services research and analytics.

AND In addition to the above requirements, the following are also required:

• Significant experience working with excel, databases, and ability to learn computer applications for analysis.
• Comfortable in a multicultural, complex, cross-functional, and dynamic work environment, able to prioritize, multi-task, focus on goals, take accountability, and manage time well.
• Ability to take individual initiative and responsibility for assignments while working independently and in a team environment.
• Must demonstrate the ability to collaborate effectively with cross-functional teams—including clinicians, researchers, and engineers—to communicate and train on clinical workflows, healthcare coding systems, and patient classification methodologies, while providing enthusiastic leadership that drives team engagement and performance.

Additional qualifications that could help you succeed even further in this role include:

• Master's degree in health field, clinical inform