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Category: Professional (Non-Clinical)
Facility: FirstCarolinaCare
Department: FirstCarolinaCare
Schedule: Full Time - 36+ hrs/wk
Shift: Day Shift
Hours: 8:30a-5:00p
Job Details:

The Senior Clinical Data Analyst works collaboratively with the Managed Care Organization’s Clinical Management Team to guide efforts to achieve excellence in health care service delivery, clinical resource management, clinical outcomes and cost-efficiency within the defined health care community.  The Senior Clinical Data Analyst manages clinical data and produces meaningful reports, is proficient in using all Microsoft products and applications, other clinically-oriented applications and software programs, databases and warehouses. The Senior Clinical Data Analyst is responsible for producing standard and adhoc reports for the Clinical Management Team used to direct program internal and external initiatives and measure success.  This individual is detail-oriented, has excellent problem-solving and time-management skills, and is able to assess accuracy and completeness of reports.  The ideal candidate has the insight and ability to independently create additional reports that may prove valuable to the management team.

Creates and maintains various databases to capture and report on important elements related to clinical initiatives and established programs.Develops appropriate queries to obtain needed clinical information collected in a database, data warehouse, software programs, electronic medical record systems, or other data collection system, as required or  requested by Health Services department. Produces standard reports on an established timeline from various data collection sources to track results, member outcomes, benchmarks and measurements connected to various health care pathways, clinical protocols, clinical and quality improvement initiatives, physician profiles and report cards, among other clinical report production assignments. Creates, maintains and provide a Clinical Dashboard for Clinical Leadership Team.Participates in planning meetings to assess the value of new software programs offered by vendors.Coordinates IS and IT needs for the annual and ongoing HEDIS initiative.Enters information as required into the HPMS system maintained by CMS for Medicare.Under the direction of the clinical management team, provides the clinical reports required via assigned and secure portals to accrediting organizations, CMS, the Department of Insurance and other agencies as indicated.Based on the analyses of data, elevates issues, trends, areas for improvement and opportunities for Clinical Management staff. Designs and creates charts, graphs, tables and reports to support findings and develop recommendations as needed for Management Presentations.Conducts research, analyses, presentations and reports as needed by the Clinical Management team.Provides monthly status level reporting for goals achievement.Coordinates and works collaboratively with delegated organizations on clinical and financial data-tracking measures related to health care service delivery, utilization management, quality improvement and other clinically-related projects. Adheres to policies and procedures of organization, including requirements to protect PHI, maintain confidentiality and adhere to HIPAA.

Master’s degree in Health Information Technology, Health-Related degree, Business Administration, Management Information Services, preferred.Bachelor’s degree with a minimum of five (5) years of transferable experience, in lieu of Master’s degree. Experience in a clinical or managed care environment working with clinical application implementation, clinical information and data management, and clinical information technology.Capability to work with various programs and application reporting tools required. Proficiency with Microsoft Office applications, including Excel and Access. Understanding and application of knowledge related to managed care products and health care benefits. Understanding of Continuous Quality Improvement and Benchmarking. Demonstrated analytical skills within a hospital or clinical setting beneficial (Acute and Non-Acute). Understands applicability of pertinent accreditation guidelines, such as NCQA and URAC, in the clinical data management process.Demonstrated ability to establish and build strong relationships across a broad range of personality type.Demonstrated ability to communicate effectively with clinical and information technology personnel verbally and in writing.Demonstrated customer orientation. Excellent leadership and teaching abilities.



 



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