Healthcare Payor Client Solutions Analyst

Avalon Healthcare Solutions, headquartered in Tampa, Florida, is the world’s first and only Lab Insights company, bringing together our proven Lab Benefit Management solutions, lab science expertise, digitized lab values, and proprietary analytics to help healthcare insurers proactively inform appropriate care, reduce costs, and improve clinical outcomes. Working with health plans across the country, the company covers more than 36 million lives and delivers 7-12% outpatient lab benefit savings. Avalon is pioneering a new era of value-driven care with its Lab Insights Platform that captures, digitizes, and analyzes lab results in real time to provide actionable insights for earlier disease detection, ensuring appropriate treatment protocols, and driving down overall cost.

Studies show that 30% of clinical laboratory testing is unnecessary or overused. Inappropriate testing or missing a key screening can lead to complications and expense arising from unwarranted care, or not obtaining proper care when needed, leading to increased health risks and costs. Avalon helps ensure delivery of the right test, at the right time, and in the right setting. We seek to ensure the most effective patient treatment, improve clinical outcomes, and optimize cost and affordability.

Avalon is a portfolio company of Francisco Partners, a global private equity firm that specializes in investments in technology and technology-enabled service companies.

Avalon is a high growth company where every associate has an opportunity to make a difference. You will be part of a team that shapes a new market and business. Most importantly, you will help Avalon to achieve its mission and improve clinical outcomes and health care affordability for the people we serve.

For more information about Avalon, please visit www.avalonhcs.com.

Avalon Healthcare Solutions is proud to be an equal opportunity employer including disability/veteran. We are committed to equal employment opportunity regardless of race, color, ancestry, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, gender identity or Veteran status.

Avalon Healthcare Solutions provides and maintains a drug-free workplace for its employees.

For more about Avalon, please visit our web site at http://www.avalonhcs.com.

About the Healthcare Payor Client Solutions Analyst:

The Client Solutions Analyst is a member of the Operations team responsible for supporting the Customer Success, Account Management teams and Health plans. As a pivotal part of our team, the Customer Solutions Analyst will ensure that our customer support operations excel in meeting client needs and expectations, driving customer satisfaction through managing various day-to-day operational activities. This position is accountable for supporting and monitoring program service delivery for clients working cross-functionally with all Avalon operational areas. The Client Solutions Analyst will report to the Senior Manager, Operations.

This position is eligible for remote work, but quarterly travel to the corporate office in Tampa, Florida is required.

Healthcare Payor Client Solutions Analyst – Essential Functions and Responsibilities:

• Minimum of 7 years’ experience in the healthcare industry


• Bachelor’s degree or significant and relevant direct work experience in lieu of degree


• Support the Customer Success Team in day-to-day operations and client communications


• Assist Account Management with client inquiries, updates and reporting.


• Develops and maintains a deep understanding of our core products and systems, works with technical and product teams to articulate product capabilities to clients


• Facilitate client onboarding processes and ensure that client interactions are logged and documented.


• Develop and provide training sessions and demonstrations to clients on how to use our products and services.


• Assists clients with user acceptance testing and educating clients on changes to products and systems


• Queries and builds client impact reports.


• Liaison and escalation point for internal Client Success Team


• Analyze customer data to identify trends, prepare reports, and make recommendations to improve customer experience.

Healthcare Payor Client Solutions Analyst – Minimum Qualifications:

• Willingness and ability to travel up to 20% of the week to client sites and providers, as needed


• Knowledge of the healthcare industry, payers, and regulations required, inclusive of claims processing


• Intermediate SQL knowledge (advance preferred)


• Proactive problem-solving skills with the ability to analyze complex systems


• Demonstrated health plan business acumen skills


• Strong organizational skills and ability to prioritize and manage multiple projects


• Outstanding presentational skills with an aptitude for providing meaning customer experiences


• Ability to apply systems thinking to evaluate and improve workflows and procedures


• Solid analytical skills with the ability to generate reports


• Ability to work cross-functionally to proactively communicate and to resolve issues timely


• Understand and experience working with Diagnosis and Procedure codes


• Outstanding written and verbal communication skills


• Intermediate computer skills (Excel, Word, PowerPoint, JIRA,)


• Logical, analytical mindset with a keen eye for details and accuracy


• Team oriented with a customer service focus.


• Proven ability to work in a past paced, multi-taking environment.

Healthcare Payor Client Solutions Analyst – Qualifications Preferred:

• Knowledge of reference laboratory business, and processes strongly desired


• Experience working with Commercial, Medicare and Medicaid programs


• Experience with API testing tools and claim editing systems


• Experience with facilitating educational webinars


• High proficiency in MS Office Applications and CRM software


• Certified Professional Coder

PM18