Client Solutions Manager, CMS Interoperability

Summary

Join Abacus Insights, a mission-driven technology company transforming healthcare data, as a Client Solutions Manager. You will be the subject matter expert on HL7, FHIR, and CMS interoperability mandates, leading requirements identification and development in a client-based setting. Responsibilities include managing client solutions requirements, leveraging operational expertise in healthcare data, validating requirements, coordinating user acceptance testing, and fostering strong customer relationships. You will collaborate with cross-functional teams, provide training and support, and drive process improvements. This role requires extensive experience with healthcare data and CMS interoperability solutions, along with strong analytical and communication skills.

Requirements

• 5+ years’ experience working with healthcare data
• Minimum 2+ years' experience in CMS Interoperability solutions
• Strong working knowledge of US healthcare data, including but not limited to Medical Claims, Pharmacy Claims, Eligibility, Plan, Enrollment, Clinical, and Provider
• Demonstrated success driving client-facing conversations and navigating payer and payvider organizations to identify requirements
• Bachelor’s degree in Health Care Administration, Computer Science, Business, Analytics, or equivalent experience
• 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

Responsibilities

• Develop requirements in the form of use cases and data mappings that capture the client’s requirements
• Work with client’s designated subject matter expert to understand data requirements and gather into a Business Requirements Document (BRD) or a pre-defined playbook or specification
• 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 CMS mandates 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

Strong understanding of healthcare industry trends, CMS regulations, and customer needs with preference for previous payer operational experience