General Summary
Under limited supervision analyzes claims electronic health record health information exchange and other data sources to identify opportunities for clinical improvement activities and coordinates directly with the leadership of the Population Health Services Organization. Ultimately these opportunities are effectively communicated to the participating physicians of the University of Maryland Quality Care Network. Assists in determining what clinical improvement initiatives are needed and what reports and/or visualizations are necessary for the QCN to achieve shared savings within each payer contract. Serves as a liaison to the Information Services & Technology (IS&T) department to assist in the development of UMMS proprietary population health analytical tools. Delegates tasks to other team members as necessary.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
- Identify trends opportunities and needs for physician practices by using the analytics platform to define actions in effort to drive results improvement in QCN valuebased contracts while also supporting the success of UMMS in the hospital waiver program. This requires thorough knowledge of federal and commercial payer claims data files to conceptualize what reporting is possible and valuable.
- Leads statistical analysis for projects and reports.
- Provide recommendations and reports/visualizations of specific actions or work based on analysis and research.
- Track the results of implemented recommendations for progress and impact (provide pre/post analysis)
- Identify early trends that illustrate opportunities to implement corrective actions
- Make datadriven decisions based on standard health plan measures and physician group contract measures
- Quantify return on investment (ROI) to illustrate the health plan programs effectiveness
- Work with industry standard data query and analysis tools to drive business decisions
- Operate in a selfdirected work environment to accomplish goals and initiatives
- Work to implement dashboards for critical success metrics reporting and tracking on programs and implementation
- Perform various adhoc analysis to drive business decisions across all functional business groups
- Analyze manipulate and extract data from a variety of relational databases.
- Liaise with the IS&T team to ensure UMMS analytics platform meets the requirements of the QCN and the broader system in product owner capacity. Assists in guiding design decision making on the capture of claims information. Assists in the development of Tableau dashboards to support population health initiatives
- Delegates reporting and analytics tasks to data analytics team members and monitors their performance.
- Participates in the interview and selection process for other team members.
Qualifications :
Education and Experience
- Bachelors degree required. B.S. in Mathematics Computer Science or related field preferred.
- 4 years of data analysis and reporting or equivalent experience required.
- Health care experience required.
- Population Health experience strongly preferred.
- Experience leading other team members preferred.
- Strong knowledge of multipayer claims files including content and structure.
Knowledge Skills and Abilities
- Strong organizational quantitative and problem solving skills with strategic and creative thinking
- Proficient with data visualization tools such as GGPlot Tableau etc.
- Excellent oral written and interpersonal skills with the ability to communicate effectively with all levels of internal and external customers
- Strong aptitude for analytical thinking and demonstrated data skills.
- Demonstrated ability to work with large data and selfdirect in analysis to reach recommendations and conclusions.
- Experience with qualitative and quantitative analytical techniques in order to measure the effectiveness and efficiency of program management practices.
- Knowledge and expertise with payer claims files and proven ability to generate analytical reports based on this data.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Compensation:
Pay Range: $42.64$64
Other Compensation (if applicable):
Review theUMMS Benefits Guide
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Remote Work :
Yes
Employment Type :
Fulltime