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Start the day excited to make a difference...end the day knowing you did. Come join our team.
The Senior Analyst, Ambulatory Clinical Integration is responsible for the design, implementation, and performance of services to support ongoing and focused professional practice evaluation (quality review) for the Alliance and MWMG Providers. The Senior Analyst will educate staff on governmental and commercial quality indicators that necessitate compliance with value-based initiatives and other regulatory requirements relevant to quality reporting and reimbursement.
This position will be responsible for working with medical staff leaders on the design of practitioner-specific performance quality dashboards including providing guidance on the development of performance and incentive criteria. The Senior Analyst will work collaboratively with the Alliance and MWMG Staff to assure that performance data is integrated into the Epic and CERHT certified EHR's.
Essential Functions & Responsibilities:
- Designs, Implements, generates, and disseminates practitioner-specific performance feedback reports/profiles.
- Gathers, compiles, models, validates, and analyzes crucial quality data.
- Conducts research and performance reporting for MWHA clients (Providers, Employers, and Payers).
- Consults with clients on benefit design and changes.
- Coordinates Client contracting, invoicing, and new client implementation.
- Designs and implements an information management system Dashboard that supports management of practitioner-specific performance data including trend analysis and peer review conclusions, in collaboration with the Information Services Department.
- Develops and manages projects, establishes project timelines and milestones/deliverables. Determines and communicates project expectations to project managers, owners, sponsors, team members, and other stakeholders in a clear and concise fashion.
- Reviews existing plans and make recommendations for changes.
- Develops Epic based reports and dashboards for Alliance/MWMG, Quality and Patient Safety, and Hospital Administration.
- Provides ad hoc training and user feedback to support greater organizational self-service reporting capabilities using Epic tools, including Reporting Workbench, Radar Dashboards, Caboodle, and SlicerDicer.
- Works with leadership to design and implement workflows and care models that support quality and clinical integration.
- Meets regularly with Physician Members to develop and implement policies and procedures to obtain feedback regarding delivery system issues.
- Demonstrates and communicates the connection between the CI program and the system's strategy in the marketplace.
- Develops initiatives in partnership with key stakeholders, for providing more effective health care, to include designing new approaches to health care delivery.
- Oversees electronic transfer of data and ongoing maintenance, Cost Analysis, and Claims Analytics.
- Configures wrap-network to ensure full integration of data sets, SFTP, SQL, SAS
- Assigns member network attribution, coordinates mapping of memberships.
- Coordinates discussions with IT system vendors to effectively implement a CI network solution.
- Provides oversight and coordination of enrollment, eligibility, medical history, and lab data transfer, pharmacy data, claims data both submitted and adjudicated.
- Trains member physicians and practices on clinical integration support technologies.
- Performs other duties as assigned.
Qualifications:
- Bachelor's degree in business, Mathematics, Finance, Computer Science, Informatics Management, or related field. Master's degree preferred.
- 5-7 years of work experience in healthcare setting, including database management, information management, informatics, accounting, project management required.
- Epic Cogito and Caboodle Certification required within 1 year of hire.
- Minimum of 5 years analytical experience skill set to include previous work with analytics, relational databases, claims database repository, business intelligence analytics required.
- Familiarity with Oracle, SAP, SAS, SQL, Microsoft Word, Excel, Access and PowerPoint preferred.
- Prior work experience in the following disciplines preferred: medical staff quality/peer review, healthcare quality, performance improvement, risk management, and utilization/case management.
- Knowledge of Joint Commission and CMS standards pertaining to credentialing, ongoing and focused professional practice review (peer review), and performance improvement.
- Knowledge and work experience involving clinical data abstraction, data presentation, and statistics.
- Requires strong organizational, time management, oral and written communication skills.
- Demonstrates solid understanding of the business and financial implication of a major health care system.
- Excellent oral and written communication skills.
- Demonstrated skills in Quality Improvement and operational improvements methods (i.e. "Lean")
As an EOE/AA employer, the organization will not discriminate in its employment practices due to an applicant's race, color, religion, sex, sexual orientation, gender identity, national origin, and veteran or disability status.
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Mary Washington Healthcare
Feb 25, 2025