HEDIS Business Information Consultant, Onsite

2 weeks ago

Linthicum Heights, United States University of Maryland Medical System Full time
Job DescriptionJob DescriptionCompany Description

The University of Maryland Medical System is a 14-hospital system with academic, community and specialty medical services reaching every part of Maryland and beyond. UMMS is a national and regional referral center for trauma, cancer care, Neurocare, cardiac care, women’s and children’s health and physical rehabilitation. UMMS is the fourth largest private employer in the Baltimore metropolitan area and one of the top 20 employers in the state of Maryland. No organization will give you the clinical variety, the support, or the opportunities for professional growth that you’ll enjoy as a member of our team. 

Job Description

General Summary

This position is part of the UMMS Population Health Service Organization Value Based Care (VBC) Quality Analyst Team.  Responsible for working with management and peers on the end-to-end HEDIS measures and reporting for UMMS ambulatory provider groups for VBC and Total Cost of Care Programs (TCOC).  Under minimal supervision gathers and analyzes clinical and financial data that assists with driving practice transformation, quality program compliance and improved patient care. Provides clinical data extraction expertise through analysis of population health data (clinical quality measures) extracted from practice EHR, payer data and patient experience data. Assists the clinical and quality improvement teams in identifying health care trends in health outcomes, utilization, population and disease management, and patient experience. Partners with end users to identify their reporting needs and solutions. This position will assist the practice in monitoring deadlines and deliverables to assure the practice meets program deadlines as well as reporting progress to leadership and to the convening entity on value-based care programs.

Primary duties may include, but are not limited to: 

• Knowledge of and experience with value-based models, Star Ratings, HEDIS®, NCQA Health Plan Rating measures and best practice quality improvement strategies. 

• Hands-on expertise in managing programs and projects focused on quality management, data analytics, workflow optimization, and clinical process improvement. 

• Creates and maintains databases to track business performance. 

• Analyzes data and summarizes performance using summary statistical procedures. 

• Develops and analyzes business performance reports (e.g. for claims data, provider data, utilization data) and provides notations of performance deviations and anomalies. 

• Creates and publishes periodic reports, as well as any necessary ad hoc reports. 

• Provides analytic consultation to other business areas, leadership, or external customers. 

• Data analysis and reporting encompasses a much higher level of complexity. 

• Use tools to enable HEDIS to measure deep dives and data quality review to improve HEDIS Ratings.

• Data depiction and modeling to optimized HEDIS reporting and self-service dashboard capabilities, and analyze data to identify strategies and priorities for focused improvement work. 

• Be focused on quality performance goals through project management, data analytics, and stakeholder collaboration.

Qualifications

Education and Experience

  • Bachelor's Degree in a health, science, or business field, or an equivalent level of professional experience required. Masters degree preferred.
  • Two years progressively responsible experience in quality management, population health or outcomes management, is required.
  • General knowledge of Quality Reporting programs (PQRS, MU, VBM, MIPS) is preferred. Understands quality improvement concepts and tools.
  • Experienced in EHR data extraction, analysis and presentation to Primary Care Leadership and Staff is preferred
  • Experienced in data manipulation using a variety of tools such as excel, access etc. is required.

Knowledge, Skills and Abilities

  •  Maintain a core understanding of population management, identifying patients that would benefit from population health services (patient outreach, appointments, care coordination) by using a variety of data sources Knowledge of practice transformation and the CMS Quality Payment Program, health care quality improvement concepts
  • Knowledge of population health, triple aim, and medical home concepts and has the understanding of how they are shaped by the health system and communities.
  • Knowledge of national quality organizations, including National Committee of Quality Assurance (NCQA) structure and standards and Health Plan Employer Data and Information Set (HEDIS) and National Quality Forum (NQF).
  • Ability to perform and teach analysis and problem solving principles with emphasis in quality and outcomes data gathering techniques, and management information applications to staff is required. Serves as a resource to others in the resolution of complex problems and issues.
  • Skills in developing and implementing process improvements activities that are focused on improving triple aim goals of quality, cost, and satisfaction.
  • Demonstrates ability to develop complex solutions that address quality measure compliance. Solutions may include technology updates or workflow changes.
  • Problem-solving skills with the ability to identify improvement opportunities and recommend solutions to problems
  • Intermediate MS Office Skills
  • Makes recommendations regarding the workflow that supports improved compliance.
  • Effective customer service skills, with the ability to work with all levels within the organization.
  • Effective verbal and written communication skills are necessary to advise and consult with clinical and business owners, make formal presentations of project findings and recommendations.
  • Excellent organization skills; demonstrates confidence and creativity.


Additional Information

All your information will be kept confidential according to EEO guidelines.

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