If you are an energetic Director of Value Analysis who enjoys being part of a collaborative and talented team then a rewarding career with Northeast Georgia Health System is where you want to be!
This position shall provide data analysis to support planning efforts, priorities and decsions around the objectives of the Accountable Care Organization (ACO), Episode Payment models and Value-based programs. This position shall support process and improvement initiatives.
The Data Analyst shall be skilled at integrating multiple sources of data and information to provide meaningful analyses that will serve as key insights and inputs into management decisions and the strategic planning process. The individual will manage both recurring and ad hoc data/information processes as well as report development and analysis across multiple functions. The individual will be responsible for providing end to end analytics; harvesting data, ensuring quality and accuracy, and preparing data in a suitable presentation format.
Lean/Project Management Professional (PMP) Sig Sigma Certification a plus.
Bachelor's degree required, Master's degree (M.A.) is preferred in Industrial/Health Systems Engineering, statistics, Health Care Analytics or the like.
Minimum of 7 - 10 years experience. Subject matter expert around data analytics and analytical systems.
Experince in quality and performance cost metrics and metric design/communication desirable. Experience working with a clinically integrated network (CIN), ACO, bundled payments arrangements and EPIC systems strongly perferred.
Shall analyze and interpret CMS and other payer supplied data to identify trends and patterns to support informed decision making. Shall proactively identify potential issues in processing and operations based on anomalies or exceptions in the data.
Shall conduct cost and quality outcomes analysis to support care redesign, contract negotiation and performance and issue resolution. Audits CMS reconciliation reports to identify discrepancies with assigned physicians, beneficiaries, NPRA, DRGs, etc. Shall investigate, file appeals as deemed necessary and follow through to resolution.
Shall create data analytics tools and reports that can be used by the board, committees, staff, and providers that facilitate the understanding of the program's goals and improvement opportunities. Interprets payer data files and produces trend reports and KPI analysis for management purposes. Responsible for developing, implementing, and managing reliable/effective quality and performance analytic systems or tools.
Systems development shall be focused around standardization and effectively supportive of national benchmarks and other performance metrics as required by participation in quality based healthcare initiatives with payers and community providers. Work to implement customer dashboards for critical success metrics reporting and tracking on programs and implementation. Maintains focus on improvement such that ongoing efforts and outcomes are sustainable and advanced enough to position the system for optimal performance and reimbursement.
Analyze, manipulate and extract data from a variety of relational databases. Shall participate in technical design sessions and provide input based on current data status and anticipated data impacts. Processes reports/files from the CMS portal for the ACO and other related programs Participates in CMS webinars that support the data analysis process.
Communicates findings that require intervention and changes to processes. Shall ensure that our external data partners receive all necessary reports in a timely manner; follows-up on outstanding items. Stays current of risk adjustment requirements, processes, deliverables and deadlines.
Responsible to understand how episode pricing is constructed and what is included and excluded from the episode. Operate in a self-directed work environment to accomplish goals and initiatives. Responsible for working with multiple levels within the organization and external clients.