Senior Healthcare Functional Consultant
Contract Corp To Corp
Contract Independent
Contract W2
24 Months
No Travel Required
Remote
Depends on Experience
Kaizen Soft Solutions, LLC
Fitment
Dice Job Match Score™
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Job Details
Skills
- Acceptance Testing
- Agile
- Authorization
- Business Analysis
- Business Operations
- Business Process
- Collaboration
- Communication
- Data Link Layer
- Documentation
- Health Care
- Health Care Administration
- Functional Requirements
- Life Sciences
- Management
- Revenue Management
- Salesforce.com
- RCM
- Software Design
- Stakeholder Management
- Testing
Summary
Position: Senior Healthcare Functional Consultant
Location: Remote
Duration: Long term
Experience: 9 - 10 years
Domain: Healthcare Provider
Preferred Industry Experience: Oncology / Specialty Care
Role Summary:
We are looking for a Healthcare Functional Consultant with strong experience in patient access and authorization workflows within provider-side healthcare environments.
The role will focus on understanding business processes across Prior Authorization, Eligibility & Benefits Verification, and Financial Clearance, and translating them into structured functional requirements and workflow designs.
The ideal candidate should be comfortable working with cross-functional teams and supporting solution design, implementation, and testing.
Experience in an oncology provider environment is preferred, not mandatory, including familiarity with workflows supporting chemotherapy, procedures, radiology, infusion, treatment readiness, and reimbursement coordination.
Key Responsibilities:
• Gather and document business and functional requirements across patient access workflows
• Define current-state and future-state workflows, including process steps, decision points, and exceptions
• Translate business needs into:
o Functional requirements
o User stories
o Process flows
o Acceptance criteria
• Support solution design across:
o Prior Authorization
o Eligibility & Benefits Verification
o Financial Clearance
• Identify process gaps, inefficiencies, and handoff issues
• Work closely with business, operations, product, and technology teams
• Support UAT, defect validation, and requirement traceability
• Maintain structured and clear functional documentation
Required Skills:
• Strong understanding of patient access workflows in provider-side healthcare
• Hands-on experience in at least 2 of the following areas:
o Prior Authorization
o Eligibility & Benefits Verification
o Financial Clearance
• Strong skills in:
o Requirements gathering
o Workflow analysis
o Process mapping
• Ability to translate business needs into clear functional documentation
• Strong communication and stakeholder management skills
• Ability to work with both business users and technical teams
Good to Have (Not Mandatory)
• Exposure to:
o Revenue Cycle Management (RCM) downstream processes
• Understanding of:
o Payer-driven workflows
o US healthcare reimbursement models
• Experience with:
o Case management or workflow platforms
o Salesforce or similar systems
• Experience working in Agile environments
• Exposure to specialty care or oncology workflows
Experience Required:
• 7+ years of experience in
o Healthcare operations
o Functional consulting
o Business analysis
• Experience in provider-side US healthcare environment preferred
Education:
• Bachelor’s degree in any discipline
• Degrees in Healthcare Administration, Life Sciences, or related fields are preferred but not mandatory.
Know anyone who might be interested?
Kindly let me know if you have any Suitable Candidates available for this opportunity.
📧
📱 +1
Kindly let me know if you have any Suitable Candidates available for this opportunity.
📧
📱 +1
Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
- Dice Id: 91135200
- Position Id: 9004871
- Posted 1 day ago
Company Info
Kaizen Soft Solutions is a growing software solutions provider based out of Tampa, Florida, in the United States. We focus on delivering high value to clients through integrated, reliable, responsive, and cost-effective solutions. We have been a trusted partner to several small, medium, and large companies, enabling them to overcome critical business challenges.
We have profound experience and expertise in providing solutions for complex IT implementation projects and integrating emerging technologies in a dynamic environment.
Our cutting-edge solutions make us a seamless extension of our clients. With our dynamic, scalable, resilient, and responsive offerings, we ensure rapid growth and high value for our clients.
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