Clinical Outcomes Analyst
2 weeks ago
The Clinical Systems Analyst at Premier Health is a qualified nursing professional with extensive knowledge in process evaluation, clinical outcome data assessment, and utilization management. This role requires proficiency in information systems and adherence to regulatory standards.
The Clinical Systems Analyst is well-versed in the evolving landscape of care delivery and understands its implications for third-party reimbursement.
This position is crucial for fostering clinical and financial integration throughout the healthcare continuum while ensuring the organization’s clinical and financial integrity.
QUALIFICATIONS:
Education:
Bachelor’s degree in Nursing
Licensure/Certification/Registration:
Valid Registered Nurse license in Ohio. Certification in a clinical specialty is preferred.
Experience Required:
- Minimum of 5 years in a related field
Prior Job Titles or Experience:
Case Management, Utilization Review, Clinical Nursing
Specific Functional Responsibilities:
N/A
Preferred Experience:
Familiarity with hospital reimbursement processes, third-party billing, and governmental regulations.
Other Experience Requirements:
At least 1 year of experience in utilization management or case management, along with knowledge of InterQual and MCG, or 5 years of relevant clinical experience in adult care. Proven experience in process improvement is essential.
Knowledge/Skills:
Proficient computer skills are necessary, including Microsoft Word, Microsoft Excel, and EPIC.
Experience in data collection, monitoring performance indicators, and feedback systems is required.
Strong interpersonal and communication skills are essential.
Ability to research, assess information, analyze issues, and provide sound recommendations is necessary.
Demonstrated skills in conflict resolution and assertive communication are required.
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