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 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 viable technology solutions.
Good To Have:- 5 years of experience
- Bachelor or Masters degree in related health or finance field ex informatics or bioinformatics
- SQL expertise
- Prior experience working as a Population Health analyst in the Healthcare system
Must Have:- Demonstrate strong domain expertise in Payor-Provider ecosystem, Medicare, Medicaid, and other relevant healthcare programs.
- Work with stakeholders to discover, clarify, and document current and future data needs.
- Perform mapping of Population Health and Care Management data to a normalized data model.
- Serve as a subject matter expert on Population health data domains such as Care Management, Utilization Management, Quality Scores, HEDIS, Care gaps.
- Build data concepts to support Population Health use cases.
- Serve as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.
- Act as a quality consultant and subject matter expert, performing testing and validation of data element mapping to standards.
- Collaborate with technical resources to perform root cause analysis and complete remediation of data quality issues.
- Work with customers to clarify and plan for their current and future technology needs.
- Design and implement projects requiring systems integration, small teams and multiple technical platforms.
- Conduct Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
- Collaborate on driving improvement activities to achieve department and organizational goals.
- Coordinate with functional team to assure consistency and optimization of overall work product.
- Assume a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
- Maintain current knowledge of industry and business process trends and apply that knowledge to existing business processes.
- Provide subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation.
- Identify opportunities for process improvement and make recommendations that lead to improvements.
- Monitor task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality.
- Escalate process and project issues that cannot be resolved.