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Job Description
PEM (Prospective Episode Manager) Implementation Consultant – Contract
Role Summary
We are seeking a contract-based Prospective Episode Manager (PEM) Implementation Consultant to stabilize and support ongoing PEM deployments. This role will provide hands-on expertise in system configuration, contract loading, and audit processes, while enabling successful delivery for key client implementations and strengthening internal capabilities.
Key Responsibilities
1. Implementation Leadership (MSK, Mayo, CHLA)
Lead system configuration, contract loading, and validation/audit activities for active PEM implementations
Ensure accurate setup of complex episode-based reimbursement models and contract logic
Partner with product, delivery, and client teams to drive implementations to production
Identify and mitigate risks related to data, contract interpretation, and pricing accuracy
2. Product Expertise & Stabilization
Provide subject matter expertise on PEM workflows, including claims processing, episode bundling, and pricing validation
Support issue resolution related to system stability, contract configuration, and data alignment
Help standardize repeatable processes for contract loading and implementation execution
3. Knowledge Transfer & Enablement
Lead structured knowledge transfer sessions to internal product, delivery, and commercial teams
Document best practices for PEM configuration, contract loading, and audit processes
Enable internal teams to independently support, implement, and position PEM going forward
Required Qualifications
Minimum 3+ years of hands-on experience with Prospective Episode Manager (PEM)
Strong domain knowledge in contract management, episode-based reimbursement, or value-based care models
Proven experience with:
Contract loading and validation
System configuration and implementation workflows
Claims and reimbursement data structures (e.g., UB/1500 claims)
Ability to translate complex contract terms into system configuration
Engagement Details
Type: Contract / Consultant (PRN/Temporary)
Duration: 9-month engagement aligned to implementation timelines
Hours: Full-time (~40 hours/week)
Focus: Delivery execution + internal capability building
Success Criteria (3 Goals)
Successful execution of PEM implementations for MSK, Mayo, and CHLA (on time, accurate configuration)
Stabilized implementation processes with reduced dependency on individual expertise
Complete knowledge transfer, enabling internal teams to support, implement, and sell PEM independently
