• Healthcare Business Analyst - Payformance Solutions

    Location US-IL-Chicago
    # Positions
    Current Opening
  • Overview

    Why we’re excited to get to work:

    The mission for Payformance Solutions is simple. We aim to be a catalyst for payment transformation in the healthcare industry. Our proprietary software solutions allow payers and providers to focus on what really matters: providing patients with access to care that yields the best health outcomes, at the lowest costs.


    The healthcare industry is complex and fragmented. Payers and providers are faced with a lack of transparency and conflicting financial goals that fail to consider the health outcomes of patients. Payformance Solutions offers data-driven, turnkey software solutions that provide payers and providers with the technical tools and resources needed to design, evaluate, build, measure, and negotiate value-based reimbursement contracts — as a neutral third party. Our holistic solutions allow payers and providers to collaborate in an ecosystem that aligns financial goals with patient outcomes.


    About You: 

    We are looking for a motivated Healthcare IT Business Analyst to join our Chicago based team. We want candidates who thrive with the ability to critically evaluate information gathered from multiple sources. In addition, be a self-starter that will work with healthcare claims data to generate insights to help solve complex healthcare transformations facing payers and providers. As well as constantly learning from our clients about the challenges they face with regard to moving to Alternative Payment Models (APMs) e.g., Value-Based Care (VBC)


     What you’ll do:

    • Provide analytical and consulting support:
      • Evaluating health plans value-based contracting strategies including contract structure, reporting capabilities, data management, settlement process, and provider performance improvement.
      • Perform analysis using big data sources that provide insight and value
      • Assist in creating reports and provide timely analysis
      • Analyze and document business processes, workflows and use cases for system design and health information exchange
      • Plan and facilitate functional design sessions
    • Conduct research regarding trends in
    • Conduct research of national claims data, medical billing payment standards, business processes, value based contracting processes, quality measurement, clinical data collection, reporting tools, and vendor products / services
    • Assist with data / business analytics needs
    • Utilize a diverse array of technologies and tools to deliver insights: Python and SQL.
    • Work with project managers to identify and document technical tasks
    • Develop testing, validation and implementation plans and processes
    • Provide support for the Payformance sales efforts, as requested.


    • Strong interest in health care and health reform
    • Bachelor’s degree with a strong academic record
    • Strong analytical capability as demonstrated by prior experience and or academic projects
    • Demonstrated ability to critically evaluate information gathered from multiple sources, produce requirements documents, develop use cases and process flow charts, create presentations, and to capture, track and report statistical data
    • Strong interpersonal skills and demonstrated ability to work effectively with team members and clients
    • Demonstrated aptitude at using advanced computer software including databases, OLAP tools and statistical software
    • Experience in Microsoft Office including Excel, PowerPoint, Word, Access
    • Proven ability to effectively communicate with both technical and non-technical team members
    • Proven ability to effectively work both independently and within a team
    • Knowledge of clinical terminologies such as ICD-10, ICD-9, CPT, HCPCS, DRG and NDC
    • Knowledge of interfaces/data sharing standards such as HL7, IHE,FIHR, 837/835
    • Experience on healthcare related projects developing and documenting technical requirements based on business requirements using interviews, document analysis, site visits, business process descriptions, use cases, scenarios, business analysis, task and workflow analysis preferred 

    Not to boast, but a little bit about us:

    Payformance Solutions is a health-tech company dedicated to advancing payment transformation in the healthcare industry. We are a wholly owned subsidiary of Altarum Institute, a nonprofit systems research and consulting organization that has been servicing government and private sector clients since 1946.


    Altarum Institute (Altarum) is a nonprofit organization headquartered in Ann Arbor, Michigan. Altarum serves the public good by solving complex systems problems to improve human health. Altarum creates and implements solutions to advance health among vulnerable and publicly-insured populations. Public sector clients include the U.S. Department of Defense, Department of Health and Human Services, Department of Agriculture, Department of Veterans Affairs, the Occupational Safety and Health Administration, and various state agencies nationwide. Altarum also serves clients in the philanthropic and private sectors. Areas of expertise include health data and analytics; value-based care; public health systems design, development and information exchange; behavioral health and substance use disorders; childhood and adolescent health; medical education; food and nutrition; consumer engagement; elder care; health disparities and equity; and military and veterans’ health.


    At Payformance, we don’t just accept difference - we celebrate, support, and thrive on it for the benefit of our employees, our clients, and our community. Payformance Solutions is proud to be an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to, among other things, race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, status as a protected veteran, or disability.


    To all recruitment agencies: Payformance does not accept agency resumes, we are not responsible for any fees related to unsolicited resumes.


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