HealthCore, Inc, a health services research firm headquartered in Wilmington, DE, is currently seeking an Implementation & Coding Consultant to work in our Wilmington, DE office. Founded in 1996, and now an independently-operating subsidiary of Anthem, Inc., HealthCore provides the health care system, biopharmaceutical industry, academia, and the Federal Government with "real-world" data to improve the quality, safety, and affordability of healthcare. HealthCore’s projects range from retrospective to large-scale, prospective studies in the areas of drug, vaccine, and medical device safety surveillance, risk management, pharmacoepidemiology, health outcomes, pharmacoeconomics, and comparative effectiveness research.
The Implementation & Clinical Coding Consultant is responsible for the analysis of existing coding nomenclatures and the development, implementation, and evaluation of medical and pharmacy coding nomenclature updates, clinical code sets and algorithms, and coding nomenclature strategies for HealthCore.
Responsibilities include: • Conceptualizing approaches to utilization of integrated coding nomenclatures and data sources into deliverables that consider both the varied business issues and objectives across HealthCore. Standarized and detailed project specific applications of the coding strategies will be integrated as considerations for research, analytic and reporting systems.[HD1] • Collaborating in the development of solutions that include integration of clinical data elements obtained from medical record abstraction processes, data warehouse data, care management systems, and other data sources, including registries and clinical trial data elements. • Communicating and monitoring the execution of standardized coding practices in collaboration with clinical and operations stakeholders throughout HealthCore. • Maintaining the standardized coding library for use by HealthCore analysts and researchers. •Collaborating in the development of a Wiki information sharing structure as a subject matter expert. • Collaborating with project teams in developing and implementing customized coding algorithms for specified projects. • Developing and managing the quality assurance process to ensure accurate code assignment on policies and within translation of research and analytic systems/tools. • Collaborating to improve coding systems embedded within all processes, tools, and measures that standardize and improve performance related to implementation and demonstrates quantifiable value to business units. Facilitates identification and resolution of local coding implementation issues
Requires a BA/BS; 5 years of related medical policy experience and coding experience using ICD-9/10, CPT, HCPCS, DRG and other claims based coding nomenclatures; At least 3 years of experience working with clinical coding nomenclatures like SNOMED-CT, LOINC and RxNorm. Prior experience leading large, multi-stakeholder regional or enterprise projects; or any combination of education and experience, which would provide an equivalent back-ground.
In addition to a dynamic work environment, HealthCore offers a competitive salary and an outstanding benefits program, including a 401(k) plan; health, dental, and vision insurance; discounted fitness club membership; life, AD&D, short and long-term disability insurance coverage; tuition assistance, employee stock purchase plan, and paid parking. Relocation is desired but not required.
HealthCore is located in Wilmington, DE, midway between New York City and Washington, DC, with offices in Alexandria VA and Andover, MA. As an independently operating subsidiary of Anthem, Inc., HealthCore offers the resources of the nation’s leading health benefits company in a small company environment.