Client Solutions Manager

Summary

Join Abacus Insights, a mission-driven technology company transforming healthcare data, as a Client Solutions Manager. You will lead requirements gathering and analysis for solutions supporting payer clients, focusing on Medicaid regulations, MCO operations, health equity, and quality measures. Leveraging your operational experience and knowledge of Medicaid operations and healthcare data, you will develop business requirements, validate solutions, and manage client UAT. This role demands strong analytical skills, cross-functional collaboration, and exceptional client engagement. You will work closely with various teams, including technical business analysts, project managers, and data engineers, to implement client projects and improve processes. The ideal candidate possesses a Bachelor's degree, 5+ years of operational experience in quality management programs focused on Medicaid, and a strong understanding of US healthcare data.

Requirements

• Bachelor’s degree in Health Care Administration, Computer Science, Business, Analytics, or equivalent experience
• 5+ years operational experience in quality management programs with a focus on Medicaid processes.  Minimum 2+ years' experience in HEDIS, Stars or quality related work.  Strong working knowledge of US healthcare data, including but not limited to Medical Claims, Pharmacy Claims, Eligibility, Plan, Enrollment, Clinical, and Provider
• Strong understanding of healthcare industry trends, Medicaid regulations, and customer needs with preference for previous payer operational experience
• Demonstrated success driving client-facing conversations and navigating payer organizations to identify requirements
• Business domain expertise and associated technical proficiency to deliver solutions that meet the client’s needs within healthcare quality data domain
• Demonstrated experience navigating complex Payer and Payvider environments as an analyst or a consultant eliciting a client’s business requirement and building relationships
• Strong communicator who can leverage their domain expertise effectively with the client and build working relationships with internal and external team members.  Ability to communicate succinctly and clearly, both verbally and written, across technical and non-technical audiences at multiple levels
• Analytical thinker with the ability to understand and document business processes; elicit and identify implied requirements, extract insights, and translate them into comprehensive and cohesive requirements and requirement plans
• Ability to de-escalate customer complaints
• A high level of project organization, attention to detail, and time management
• "Roll up your sleeves mentality" working side-by-side with your team
• Demonstrated ability to thrive in a fast-paced, dynamic startup environment

Responsibilities

• Develop business requirements in the form of use cases that capture the client’s requirements.  Work with client’s designated subject matter expert to understand business requirements and gather into a Business Requirements Document (BRD). This may include elaborating on requirements with the client, capturing acceptance criteria, and identifying non-functional requirements. Requirements scope can vary across a broad range of client deliverables including reports, dashboards, data extracts or views into the data used by the client for operations or analytics
• Use your operational experience and knowledge of Medicaid operations and healthcare data to triage business requests and requirements
• Perform a set of tests against the delivered solution and confirm all acceptance criteria are met before turning over the solution to the client. This is a validation step performed by the author of the business requirements with assistance from other team members to simulate the actual client user acceptance testing (UAT) as a precursor to the client’s actual UAT. This activity compliments core testing performed by the Abacus QA team
• Laise with the client and partner with team members to coordinate and progress the client’s UAT
• Partner with Account Management, Program Management, Sales, and Product Management to develop strong customer relationships, resulting in reference customers
• Work closely with cross-functional teams, including business experts, technical business analysts, project managers, account executives and data engineers to successfully implement client projects.  Collaborate with Product Management to identify client-specific requirements that may translate into an existing standard product feature or a future feature on the product roadmap
• Provide training to internal teams on business needs and use cases for seamless client implementation. Provide ongoing support to address questions and issues raised by the implementation team
• Serve as a bridge between the client and Abacus technical teams, effectively communicating business requirements to team members
• Own and manage all net new requests from client, tracking resolution using internal project management tool
• Become educated and understand the strategy of new product launches, new features, and product upgrades, and how they support the client
• Conduct process analysis, process evaluation, and implement process improvements that lead to better solutions and client satisfaction

Preferred Qualifications

The ideal candidate will be organized, self-motivated, and able to complete complex tasks with little supervision.  The Client Solutions Manager will be encouraged to remain current with market trends by participating in educational opportunities, reading professional publications, maintaining personal networks, and participating in professional organizations. This individual will be required to work with internal and external departments and able to position products, solutions, and services to be highly competitive to address market and client needs