Terms of Employment
- Contract-to-Hire, 12 months
- This is 100% Remote Opportunity – Candidates must reside in Maryland, Washington, DC, Virginia, West Virginia, Pennsylvania, Delaware, New Jersey, New York, North Carolina, Florida, or Texas.
Overview
Our client is seeking a Medical Policy Analyst to research, develop, and coordinate the distribution and dissemination of less complex medical policies in support of corporate philosophy, provider and member contracts, and accepted standards of medical practice.
Responsibilities
- Review the API specification for conformance of the enterprise standards and API governance framework.
- Review the documentation and make recommendations for change.
- Design and develop framework (reusable routines) using REST API Specifications and shell scripts to manage lifecycle of API’s.
- Work with CI/CD team to create necessary custom Jenkins pipelines.
- Design, develop and implement custom API flows and Publish API’s to APIM platform.
- Troubleshoot issues seen in DataPower and APIM.
- Generate reports from APIM Analytics.
- Experience with OAuth and JWT (with OpenID Connect).
- Participate in customer onboarding activities on to API Gateway platform and participate in triage activities on a need basis.
- Support production release activities.
Required Skills & Experience
- Bachelor’s Degree or Master’s degree in Nursing or related health care discipline.
- Coursework in technical writing and statistics.
- RN – Registered Nurse – State Licensure and/or compact State Licensure.
- Working knowledge of medical insurance and managed care principles and knowledge of CPT and ICD-10 coding systems.
- Knowledge of all types of medical necessity decisions including various places of service and provider types.
- Knowledge of principles, practices, evidence-based guidelines and standardized processes and procedures for evaluating medical support operations business practices.
- Excellent written and verbal communication skills, and the ability to present to internal clients of all levels.
- Ability to analyze essential facts, make timely and sound decisions, resolve performance and job-related issues.
- Demonstrated desire to share knowledge and work as a team.
Preferred Skills & Experience
- Certified Coder (CCS or CPC) – AHIMA or AAPC
nTech is an equal opportunity employer. All offers of employment are contingent upon pre-employment drug and background screenings. Only candidates who meet all of the above client requirements will be contacted by a recruiter.
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