Overview
The Analyst Population Health measures, monitors and reports quality and performance measures and serves as the main technical liaison between Population Health, providers, staff, IT and analytics and reporting vendors. He/she enables performance improvement by collecting, analyzing and reporting information which drives desired outcomes.
EDUCATION REQUIRED
Bachelor's Degree in related field from an accredited institute or comparable experience in statistics, data analysis and research methods.
EDUCATION PREFERRED
None.
LICENSURES OR CERTIFICATIONS REQUIRED
None.
LICENSURES OR CERTIFICATIONS PREFERRED
None.
EXPERIENCE REQUIRED
3-5 years working in data analysis and decision support with analytical software proficiency. Strong background and knowledge of EMR, quality reports, claims data and reimbursement quality. Strong project management experience. Experience developing effective professional relationships with physicians, nurses, office managers and provider front office staff and care coordination teams. Advanced proficiency in MS Access and Excel, electronic medical record systems, PM systems, reimbursement methodologies, TSQL programming languages and a variety of information systems and data files including large and complex files. Experience with various types and sources of health care information, including financial and patient-level data files, HL7 and various plain data formats.
EXPERIENCE PREFERRED
3 years working with ambulatory EMRs. Experience with workflow redesign. Database application development (e.g., Microsoft Access, SSRS, SSAS, Tableau).
ROLE SPECIFIC ESSENTIAL DUTIES AND RESPONSIBILITIES
- Coordinates and executes technical data collection and analysis for quality and performance measures from NCQA, CMS, governmental and commercial payors.
- Serves as one of three key members of Population Health's performance improvement team that consists of the Population Health Performance Measures Coordinator, the Population Health Outreach Coordinator and the Population Health Performance Data Analyst. Analyst conducts and presents analysis and selects specific practices and cohorts of patients for interventions. Performance Measures Coordinator coordinates data collection from providers and implements quality improvement operations with provider practices. Outreach Coordinator implements quality improvement operations with patients.
- Measures and reports final performance.
- Utilizes best practices in data collection strategies, health data standards such as HL7 and health data analytics.
- Coordinates collection, data integration and performance measures from multiple source systems using standard database and reporting tools prior to the installation and go-live of an enterprise performance analytics solution.
- Builds relational databases for storage and retrieval of data.
- Performs data retrieval and extraction, aggregation, scrubbing, preparation, reporting and analysis. Performs quantitative analyses of healthcare claims and utilization data from various internal and external sources.
- Assures the accuracy and validity of source data and results and works closely with the clinical team to interpret and make recommendations.
- Creates reporting and trending tools utilized by internal and external groups to identify various information including the following:
- Patient lists by practice
- Focus areas for case management activities
- Care gap reports for patients who qualify for various HEDIS and other quality metrics
- Referral trends among providers
- High-risk patient rankings based on diagnoses, frequency of service utilization, aggregate cost, etc.
- Patient outreach prioritization reports based on various clinical initiatives
- Coding anomalies
Maintains HIPAA privacy and security as a top priority. Complies with all privacy and security requirements as outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) pertaining to patient confidentiality and with access to confidential information including contracts, personnel information and member information.
TYPICAL PHYSICAL DEMANDS
Frequent sitting and/or standing, often for long periods of time. Frequent walking bending, stooping, pushing, twisting and turning. Occasionally lifts 10 pounds or more of office related equipment or supplies. Eye-hand coordination and manual dexterity in reaching, grasping and handling with repetitive use of hands and fingers in operating computer, calculator, telephone, copier, fax and similar office equipment. Ability to distinguish letters, numbers and symbols with normal range of vision and hearing and ability to communicate verbally and in writing. Work-related stress due to volume and time constraints. May require travel by vehicle to alternative locations.
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