Job Description

As a Healthcare Workflow Expert, you will leverage your hands-on experience with clinical systems, revenue cycle tools, and payer platforms to define and evaluate real-world workflows in healthcare settings. This role focuses on understanding how healthcare professionals utilize these systems beyond their surface-level features, making it ideal for clinicians, operators, and healthcare IT professionals. Key Responsibilities

• Map end-to-end healthcare workflows performed within specific tools, going beyond just features.
• Describe how clinical and administrative data flows across systems, from intake to processing, decision-making, and output.
• Provide deep, structured breakdowns of workflows such as prior authorization, imaging review, lab processing, and claims adjudication.
• Identify decision points, compliance constraints, and edge cases within workflows.
• Evaluate what a competent operator (clinician, biller, analyst, etc.) should be able to accomplish in each system.
• Produce clear, detailed write-ups within approximately 20 minutes per category.

• Set up a batch review assignment by distributing documents across a team of reviewers in a controlled manner, including creating a new batch set and defining batch size and source sort order.
• Identify workflows a radiologist should perform using a DICOM viewer, detailing the 10 most important workflows in the application.

• Step-by-step workflows detailing processes such as ingesting imaging studies, reviewing series, annotating findings, comparing priors, and generating reports.
• Specifics on data types (e.g., DICOM series, metadata), transformations, and outputs.
• Real-world context regarding clinical decision-making, turnaround times, and collaboration.

• Generic feature lists without depth or context.

• RCM Ops workbench
• RCM / Billing & Claims (e.g., Epic Resolute, FinThrive, R1 RCM, Craneware)
• Pharmacy Systems (e.g., ScriptPro, QS/1, Omnicell, Parata, RedSail)
• Clinical Intelligence Hub
• Utilization management / medical necessity criteria (e.g., MCG Health, InterQual, AIM Specialty Health)
• Prior authorization (e.g., CoverMyMeds)
• Drug information / clinical reference databases (e.g., First Databank, Merative/Micromedex, NCCN Guidelines)
• Population health / clinical analytics (e.g., IQVIA, Clarivate, Arcadia Analytics, Azara DRVS, Inovalon)
• Payer Admin Core (e.g., Cognizant, TriZetto/Facets, HealthEdge, HealthRules, Payer, Oracle Health, Epic Beaker)

• Hands-on experience with at least one of the listed systems; experience with multiple systems is a strong plus.
• Background in clinical care, healthcare operations, revenue cycle, or payer systems.
• Ability to articulate detailed, real-world workflows rather than just product features.
• Strong understanding of healthcare processes and data flows.
• Clear, structured written communication skills.

This role is an hourly position, expected to last approximately 8 hours in total across all experts. Based on the results, there may be an opportunity for a full long-term project commitment.

The compensation for this role ranges from $90 to $100 per hour.

This position is remote, and candidates must have the necessary equipment and internet access to perform the role effectively.

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