Population Health BA

As a Technical Analyst specializing in Population Health and Care Management, your role will involve demonstrating strong domain expertise in Medicaid and other relevant healthcare programs. Your responsibilities will include working with stakeholders to identify current and future data needs, mapping Population Health and Care Management data to a normalized data model, and serving as a subject matter expert on domains such as Care Management, Utilization Management, Quality Scores, HEDIS, and Care gaps. Additionally, you will be responsible for building data concepts to support Population Health use cases and providing technology solutions to address business and technical issues for assigned customer areas. Key Responsibilities: - Act as a quality consultant and subject matter expert, conducting testing and validation of data element mapping to standards. - Collaborate with technical resources to analyze root causes and remediate data quality issues. - Work with customers to clarify and plan for current and future technology needs, mapping existing business processes/functions, and recommending changes for system integration. - Design and implement projects involving systems integration, small teams, and multiple technical platforms. - Conduct financial analysis, including Return on Investment (ROI), to support project funding/prioritization. - Drive improvement activities to achieve department and organizational goals, ensuring consistency and optimization of work product. - Provide subject-matter expertise on Health Ministry processes, policies, and requirements for functional area process design, testing, and implementation. - Identify opportunities for process improvement, make recommendations, and monitor task assignments to ensure timely completion with the intended scope and quality level. - Escalate process and project issues that cannot be resolved internally. Qualifications Required: - Prior experience working as a Population Health analyst in the Healthcare system. - Working knowledge of relational databases/database structures, with SQL expertise desired. - Strong understanding of data collected and used in Claims, Adjudications, Health Insurance, Care, and Utilization Management. - Knowledge and experience with ambulatory and acute clinical, billing and claims workflows, and clinical information systems. - Bachelor's or Master's degree in a related health or finance field (e.g., informatics or bioinformatics). - Critical thinking skills, decisive judgment, and the ability to work with minimal supervision in a stressful environment. - 5 years of experience in a similar role preferred. Please note that this job requires a proactive approach to driving improvement activities, staying abreast of industry trends, and applying knowledge to enhance existing business processes. If you are passionate about leveraging technology to optimize healthcare processes and data management, this role offers an opportunity to make a significant impact in the field of Population Health and Care Management.,