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Garner Health

Healthcare Claims Researcher

Posted Yesterday
Easy Apply
Remote
Entry level
Easy Apply
Remote
Entry level
This role involves developing and maintaining performance measures for physicians based on claims data. Responsibilities include conducting literature reviews, validating metrics, and collaborating with interdisciplinary teams to enhance healthcare quality while reducing costs. The position calls for strong communication skills and an aptitude for working in a dynamic startup environment.
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Garner's mission is to transform the healthcare economy, delivering high quality and affordable care for all. By helping employers restructure their healthcare benefit to provide clear incentives and data-driven insights, we direct employees to higher quality and lower cost healthcare providers. The result is that patients get better health outcomes while doctors are rewarded for practicing well, not performing more procedures. We are backed by top-tier venture capital firms, are growing rapidly and looking to expand our team.

Estimates suggest that low-value healthcare leads to almost $100 billion in waste annually. Low-value care directly harms patients financially but can also have non-economic implications for them. Physicians drive this spending. Garner Health has built a business around identifying physicians who provide high-quality, high-value care.

You will be essential in helping develop and maintain Garner’s proprietary claims-based physician performance measures. You will help review academic clinical literature and work with clinical experts to understand high-quality, high-value care across a variety of specialties and identify exceptional clinicians. You will also help develop methods to statistically study these metrics, so we can prove their validity to ourselves and others. Additionally, you will be responsible for writing white papers for clients that describe the clinical reasoning and research supporting these metrics. 

Responsibilities will Include:

  • Conduct literature reviews to help develop and refine metrics for a range of medical conditions and procedures
  • Create and validate measures using proprietary technical and statistical tools 
  • Maintain a library of documentation for internal and external stakeholders
  • Work closely with clinical experts 
  • Collaborate with product, data science, and engineering teams to support new product development, figuring out creative ways to use the metrics we have developed to save the US healthcare system money and help improve quality of care for patients   

The Ideal Candidate Has:

  • Minimum 1 year working with health insurance claims data or electronic health record (EHR) data
  • Working knowledge of how to utilize ICD and CPT codes, as well as their limitations 
  • Bachelor’s degree required. Masters degree or above in public health, biostatistics, epidemiology, or related fields preferred  
  • Strong biostatistics and epidemiological background required
  • Basic coding experience (SQL, Python, Stata, R, or SAS) required 
  • Strong interest in healthcare and clinical best practices research
  • An aptitude to learn new technologies and tools quickly 
  • Strong written and verbal communication skills
  • Ability to work independently
  • A desire to work in a rapidly evolving startup environment, and be a part of our mission to improve the value and quality of the US healthcare system
    The target salary range for this position is $100,000-$115,000. Individual compensation for this role will depend on a variety of factors including qualifications, skills and applicable laws. In addition to base compensation this role is eligible to participate in our equity incentive and competitive benefits plans. 

 

Garner Health is proud to be an Equal Employment Opportunity employer and values diversity in the workplace. We do not discriminate based upon race, religion, color, national origin, sex (including pregnancy, childbirth, reproductive health decisions, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, genetic information, political views or activity, or other applicable legally protected characteristics.

 

Garner Health is committed to providing accommodations for qualified individuals with disabilities in our recruiting process. If you need assistance or an accommodation due to a disability, you may contact us at [email protected]

 

Beware of job scam fraudsters! Our recruiters use getgarner.com email addresses exclusively. We do not post open roles on Indeed, conduct interviews via text, instant message, or Teams and we do not ask candidates to download software, purchase equipment through us, or to provide sensitive information such as bank account or social security numbers. If you have been contacted by someone claiming to be a Garner recruiter or hiring manager from a different domain about a job offer, please report it as potential job fraud to law enforcement here and to [email protected]

Top Skills

Statistical Coding

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