Job Title: Clinical Informaticist
Job Summary: The Clinical Informaticist will bridge the gap between clinical and technical teams by interpreting clinical guidelines from CMS and Health Plans, and transforming them into models for automation. This role requires close collaboration with clinicians and engineers to ensure that automated models are accurate, clinically sound, and technically feasible.
Key Responsibilities:
Interpret clinical guidelines and policies from CMS and Health Plans
Build and validate clinical automation models based on policy requirements
Collaborate with clinicians (MDs, Nurses) to ensure clinical accuracy
Act as liaison between clinical, business, and technical teams
Support engineering teams through the development and QA lifecycle
Analyze clinical data and develop data mapping and transformation rules
Develop use cases, user stories, and support resolution of production issues
Required Qualifications:
Bachelor’s degree
3+ years of experience in Healthcare IT
Strong clinical understanding and experience
Familiarity with medical coding (CPT, ICD, etc.)
Experience as a Business Analyst or in a similar liaison role
Strong communication and analytical skills
Proficient in Excel, Visio; able to explain and understand technical solutions
Preferred Qualifications:
Degree in Clinical Informatics
Familiarity with CMS, MCG, InterQual guidelines
Experience with EMRs and querying using SQL
Experience analyzing large clinical datasets
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