Name of Positions: Clinical Performance Measurement Analyst III
Job Code: 01008
Job Grade: 22
Job Summary:
Under
the general direction of a Manager, Director or Vice President, apply sound
analytic methods to develop and implement projects that successfully support
various business functions and programs. Manage complex statistical analysis,
develop and execute analytical measurement and reporting of health care data
that influences strategic decision-making and health care quality improvement
for PREMERA members. Responsibilities include providing analytical expertise to
evaluate program and product effectiveness, identifying success factors and
opportunities for improvement, manipulating complex data sets, and designing
and producing analytical reports. Working closely with management and clinical
program administrators, support the achievement of program objectives by
providing analytical support and thought leadership to develop and implement
information-driven processes and solutions.
Responsibilities:
1. Collaborate with management and program administrators in the creation, implementation and evaluation of disease-based or health risk-based programs by designing, measuring and monitoring clinical process and outcomes measures, benchmarking and forecasting results, conducting cost-benefit analysis, or establishing performance goals and standards.
2. Manage quality process and outcomes analysis which may require the conceptual design of studies, sampling strategies, hypothesis testing, use of risk-adjustment methodologies, or predictive modeling.
3. Provide analytical and statistical thought-leadership to Vice President, Directors, Managers, and professional staff to identify meaningful clinical process and outcome indicators to set standards, monitor organization performance, and identify business solutions that support Corporate, Division and Departmental initiatives.
4. Manage the retrieval and analysis of data for projects requiring sophisticated inferential techniques.
5. Provide direction to and collaborate with the Health Plan Information and Analysis (HPIA) department to retrieve data necessary for performing analyses; confirm the quality and accuracy of raw data provided by HPIA.
6. Develop various analytical reports to fulfill obligations to employer groups, physician groups, or as requested by management.
7. Communicate results of project proposals and analyses to PREMERA work groups, project teams, committees, management, and/or practitioners; develop and conduct final presentations for both internal staff and external audiences.
8. Optimize analytical benefits through continuous quality improvement methods and analysis, such as statistical process control tools and develop mechanisms to track project best practices/lessons learned.
9. Manage project supporting/reference documentation including: work plans, notes, output, proof of review, reports, and other materials, in well-organized files. Mentor CPM team members on the use of successful organization methods.
10. Ensure that team and division programs and projects meet the requirements of federal and state regulatory agencies and external review organizations.
11. Consult with and/or oversee work of external entities (Medical Groups, Pharmacy Benefit Managers, Disease Management Vendors, etc.) to assure accurate and timely implementation of technical, analytic, and reporting components vital to PREMERA programs.
12. Consult with and provide analytical support to PREMERA departments needing clinical analysis assistance.
13. Represent PREMERA in external forums relevant to clinical process and outcomes measurement and improvement.
14. Identify operational issues and potential risks; develop recommendations to mitigate risks and participate with management to implement corrective action.
15. Stay abreast of new and innovative trends in measurement of health care outcomes and quality improvement as well as industry news and developments; work to build similar knowledge in CPM team members.
16. Perform other duties and special projects as assigned.
Minimum Qualifications:
1. Master’s degree in Statistics, Mathematics, Epidemiology, Public Health, Healthcare Administration or other relevant field; or Bachelor’s degree and with equivalent experience may substitute for Master’s degree.
2. Minimum of four years experience in a professional environment as clinical data analyst, preferably in a health plan or health care delivery system.
3. Solid background and understanding of health plans (including HMOs, PPOs, indemnity plans) and health care coding conventions.
4. Excellent oral and written communication skills; demonstrated ability to interpret health care data and write an effective interpretation of technical subjects for technical and non-technical audiences.
5. Proven ability to prioritize multiple requirements and define a detailed process to complete required tasks.
6. Extensive skills in Access, Excel, Word, PowerPoint, Visio, MS Project,
7. Extensive skills with statistical software packages; SAS preferred.
8. Proven experience managing and modeling of large data sets.
9. Experience conducting scientific literature searches.
10. Demonstrated ability to independently drive results, meet timelines, and manage project oversight activities.
11. Ability to develop and maintain effective working relationships across department lines, externally, and with all levels of management.
12. Experience with clinical measurement and reporting standards including HEDIS, Leapfrog, AHRQ, and CMS.
13. Experience with concepts of continuous quality improvement.
14. Ethical and Professional business behavior with ability to maintain confidentiality.
Additional Qualifications Preferred
1. Knowledge of Visual Basic, SQL programming.
2. Knowledge of PREMERA products, operations and policies.
Working Conditions:
Work is performed within a normal office environment with ambient temperatures and involving occasional reaching, stretching, bending and moving about.
Location of Openings: Seattle, WA
Contact Person: Brad Nelson
Telephone: 415-298-0638.
E-mail: Brad.Nelson@sas.com
Posted 6/23/2008