HEDIS Business Information Consultant, Onsite

Found in: Resume Library US A2 - 1 week ago

Linthicum Heights Maryland, United States University of Maryland Medical System Full time
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.

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