Note: The job is a remote job and is open to candidates in USA. Carrum Health is a health technology company focused on expanding value-based care and improving patient experiences, healthcare costs, and outcomes. The Contractor, Clinical Informatics Data Consultant will support the clinical business intelligence team by applying clinical coding, claims analytics, quality measurement, and informatics expertise to healthcare data initiatives.
Responsibilities
- Help support our clinical business intelligence team
Skills
- 3+ years of experience working in clinical informatics, healthcare claims analytics, clinical coding, quality measurement, or a closely related healthcare data role
- Strong working knowledge of clinical code sets, including CPT, HCPCS, ICD-10-CM/PCS, DRG/MS-DRG, diagnosis codes, procedure codes, and how these codes are used in claims and clinical service line definitions
- Demonstrated experience translating clinical concepts into structured code logic, including defining procedures, conditions, episodes of care, complications, exclusions, or service-line groupings
- Experience working with claims data and/or clinical quality data to support reporting, algorithm development, measure definitions, or clinical review workflows
- Ability to review code sets and determine whether they are clinically appropriate, complete, and defensible for the intended use case
- Ability to work independently with cross-functional teams, including clinical, data, product, operations, and quality stakeholders
- Strong attention to detail and ability to document coding logic, assumptions, edge cases, and recommendations clearly
- 5+ years of experience in clinical informatics, healthcare claims analytics, quality measurement, clinical coding, or a related role
- Experience supporting quality algorithm development, clinical measure development, risk stratification, provider evaluation, or outcomes reporting
- Experience working across multiple clinical service lines, especially surgery, oncology, musculoskeletal care, bariatrics, cardiovascular care, behavioral health, or other specialty care areas
- Familiarity with quality frameworks or measure programs such as CMS quality measures, HEDIS, MIPS, EOM/OCM, PROMs, complications tracking, readmissions, ED utilization, mortality review, or patient safety indicators
- Coding certification or related credential, such as CPC, CCS, RHIT, RHIA, CRC, CDIP, or equivalent experience
- Clinical background or licensure, such as RN, NP, PA, MD/DO, PharmD, or other relevant healthcare training
- Experience with claims grouping, episode definitions, service-line attribution, procedure/diagnosis mapping, exclusions, complications, and clinical edge-case review
- Familiarity with healthcare data tools or query languages, such as SQL, Excel/Google Sheets, BI tools, claims platforms, EHR data, or data dictionaries
- Experience documenting coding logic in a way that can be understood by clinical, product, data, and business stakeholders
- Prior experience working in a startup, value-based care, Centers of Excellence, provider network, payer, employer-sponsored healthcare, or digital health environment
Benefits
- Remote-first company with employees all over the United States and two office locations in San Francisco and Chicago.
- Flexible working hours for employees.
- Generous time off for employees.
- Paid parental leave for employees.
- Opportunities for employees to connect with coworkers both virtually and in-person.
- An active employee-led Diversity, Equity, Inclusion, and Justice (DEIJ) committee and several employee resource groups (ERGs).
- Employee resource groups help employees build stronger connections through social, educational, and community activities.
Company Overview