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Job Summary
Responsible for the development evaluation and innovation of Alternative Payment Models (APMs) within the El Paso Health Organization. Monitors and analyzes existing APM programs to ensure they align with overall strategic organizational goals and performance standards. Provides data and analytical support to other areas of Quality Improvement including HEDIS gap in care reporting Performance Improvement Projects (PIPs) and departmental productivity reporting. Analyzes provider performance metrics and calculates quality incentives achieved under various APM programs and other quality programs designed to increase quality in healthcare.
Skills
1. Knowledge of CMS TDI HHSC NCQA and URAC rules and standards to assure compliance.
2. Proficient in the principals of analytical assessment and creative problem solving.
3. Proficiency in Microsoft Software and SQL.
4. Has knowledge of health plan systems and organizational relationships.
5. Understands and utilizes the fundamentals of continuous quality and process improvement.
6. Excellent verbal and written communication skills.
7. Ability to meet deadlines while producing quality analyses.
8. Strong interpersonal skills as demonstrated by past work experience.
9. Highly organized and detailed oriented.
10. Selfstarter with the ability to work independently and take initiative.
11. Strong presentation skills.
12. Must be able to maintain awareness of changing healthcare industry trends and applications.
Work Experience
Three years of experience in data analysis required. Strong background in Alternative Payment Model (APM) contracting quality improvement and/or data gathering and analysis required. Must possess the ability to carry out an APM program from study and design through implementation. Strong proven project management skills preferred. Experience in an HMO and/or managed care setting is highly preferred.
License/Registration/Certification
Certified Professional in Healthcare Quality (CPHQ) preferred.
Education and Training
Bachelor degree in Information Technology Statistics Finance Accounting Business or Public Health required.
Required Experience:
Manager
Full-Time