Population Health BA

Description

Consultant Technical Analyst - Population Health and Care Management

Job Summary

• Must demonstrate strong domain expertise, particularly in the
  

Payor-Provider ecosystem, with a solid understanding of Medicare,
Medicaid, and other relevant healthcare programs

• Works with stakeholders to discover, clarify, and document current and
  

future data needs

• Performs mapping of Population Health and Care Management data to
  

a normalized data model.

• Serves as a subject matter expert on the Population health data
  

domains such as Care Management, Utilization Management, Quality
Scores, HEDIS, Care gaps

• Builds data concepts to support Population Health use cases
• Serves as a key resource for an assigned customer area to understand
  

and explain business and technical issues and to provide viabletechnology solutions.

Responsibilities

? Act as a quality consultant and subject matter expert, performingtesting and validation of the mapping of data elements to standards? Collaborates with technical resources to perform root cause analysisand complete remediation of data quality issues? Works with customers to clarify and plan for their current and futuretechnology needs. Determines and maps existing business

Processes/functions And Recommends Changes Required To Fit a Tightly

integrated system.? Designs and implements projects requiring systems integration, smallteams and multiple technical platforms.? Conducts Return on Investment (ROI) and other financial analysis tosupport project funding/prioritization.? Collaborates on driving improvement activities to achieve departmentand organizational goals.? Coordinates with functional team to assure consistency andoptimization of overall work product? Assumes a proactive role in driving improvement activities to achievedepartment and organizational goals to deliver value.? Maintains current knowledge of industry and business process trendsand is able to apply that knowledge to existing business processes.? Provides subject-matter expertise of Health Ministry processes, policiesand requirements in support of functional area process design, testingand implementation? Identifies opportunities for process improvement and makesrecommendations that lead to improvements? Monitors task assignments to ensure they are performed on schedule,within intended scope and to a defined level of quality.? Escalates process and project issues that cannot be resolved

Experience

? Prior experience working as a Population Health analyst in theHealthcare system.? Must have a working knowledge of relational databases/databasestructures, SQL expertise desired? Must have a strong understanding of data collected and used inClaims, Adjudications, Health Insurance and Care and UtilizationManagement? Knowledge and experience with ambulatory and acute clinical, billingand claims workflows and clinical information systems.? Bachelor or Masters degree in related health or finance field exinformatics or bioinformatics.? Complexity of work: Within the scope of job, requires critical thinkingskills, decisive judgment and the ability to work with minimalsupervision. Must be able to work in a stressful environment.