M.O.I Telephonic + Face2Face *Solid HealthCare Experience is MUST*
1). · Proficiency with Rule/Decision Analysis for rule based projects (ILOG). · Decision Modeling and Process Modeling are key attributes. · Excellent communication and documentation skills. · Must be able to drive rule discovery, analysis, and documentation process. · Facilitate sessions with business users/SME’s. · Assist business in identifying existing and new business rules. · Analyze rules for completeness, correctness, optimization (from a logical, not performance, perspective). Identify the impact of defined rules. · Formalize the business terms (and phrases) used in business rules; this formalization may be in a logical data model, fact model, business object model or some other format that standardizes the terms used and their definitions. · Experience in projects developed via Lombardi/BPM and/or PEGA. 2). · Experience working with Clinical applications – such as: o Authorization (and/or Referral) feeds, o Case Management o Disease Management · Skills working with Claims processing – specific to “Auth-to-Claim” matching. · Technical mapping of interfaces needed to receive/send (In-bound and out-bound) data. That data would be Membership and Provider data. · Understanding additional Clinical business functions, such as: o Correspondence Letters, Attachments and Faxes o Survey Assessments o Reports 3). *Solid healthcare experience* with Enrollment, Billing, Affordable Care Act, HIX, Software Package Integration, Middleware, ETL Data Mapping experience. Thanks & Regards Amit Sharma *Technical Resource Specialist* *RG Talent Inc.* 39120 Argonaut way Suite # 157, Fremont CA 94538 Phone : 510-443-0757 Ext-115 Fax : 510-952-4633 Email : [email protected] GTalk --> amitsharma.rgtalent YIM à amitsharma.rgtalent In my absence please contact Javed Ansari at the following address [email protected] *Disclaimer: Under Bill s. 1618 Title III passed by the 105th U.S. Congress this mail cannot be considered spam as long as we include a way to be removed from our mailing list. Simply send us an e-mail at [email protected] and we will gladly REMOVE you from our mailing list.* -- -- To unsubscribe from this group, send email to [email protected] For more options, visit this group at http://groups.google.com/group/CBE-Software-Engineer?hl=en --- You received this message because you are subscribed to the Google Groups "CBE Software Engineer" group. To unsubscribe from this group and stop receiving emails from it, send an email to [email protected]. For more options, visit https://groups.google.com/groups/opt_out.
