The Data Analyst, Intermediate, supports the Pay for Value (P4V) programs development and reporting requirements for CalOptima. The incumbent will assist with the development and production of P4V results and physician specific quality measure reports and create and maintain databases to support the business requirements of the team. Serves as a back-up to the Senior Data Analyst. Responsible for assisting with the development of internal systems and exception reporting to ensure timely and accurate data reporting and analysis while performing analysis of business needs and data integration with our Business Intelligence application.
POSITION RESPONSIBILITIES:
- Generates P4V reports on defined schedule; models new P4V metrics or changes in methodology.
- Participates in Pay for Value Steering Committee Meetings.
- Coordinates with Finance to facilitate approval of payment for earned P4V incentives.
- Prepares reports and findings; evaluates reports for accuracy of data, including the application of standardized analysis, and assists in the timely production of reports.
- Analyzes data trends compared to industry standards and recognized benchmarks.
- Provides technical expertise to staff, other CalOptima departments, and agencies working in conjunction with CalOptima.
- Supports QI, CCN, and OCC workgroups and other committees working on quality improvement activities.
- Assists in the implementation of integrated strategies to improve data collection and data integration to the business intelligence application.
- Collaborates with systems staff to ensure functional effectiveness of the interactions between operations and information systems.
- Maintains thorough knowledge of CalOptima’s data warehouse and the move to the Business Intelligence software. Assists in providing feedback to Information Systems (IS) to resolve data integrity issues and to support reporting requirements.
- Refers complex data integrity issues to the Data Analyst, Sr. and/or P4V Manager for further evaluation and action as needed.
- Completes ad-hoc analyses, special projects, and other duties as assigned by management.
Required Skills
- Meet and maintain established quality and production standards.
- Work independently and as part of a team, with multiple deadlines.
- Develop and maintain effective working relationships with all levels of the Quality Analytics staff, as well as other departments (e.g., IS, health network and provider relations), and various external customers.
- Organize, prioritize tasks and use time efficiently.
- Present information in a user-friendly format and to clearly analyze and explain content.
- Communicate clearly and concisely, both verbally and in writing.
- Work with complex databases: build queries and reports, format reports, export reports, etc.
- Utilize and access computer and appropriate software (e.g. Microsoft Office; Word, Excel, Outlook, SQL, Access and Visual Basic for Applications (VBA).
Required Experience
EXPERIENCE & EDUCATION:
- Bachelor’s degree in Health Care Administration, Business Administration, Mathematics, Public Health or a related field required.
- Master’s degree preferred.
- 2 years of experience working with databases/data warehouses; managing and interpreting patterns and trends is required.
- 3 years of professional experience in a managed health care organization is required.
KNOWLEDGE OF:
- P4V programs and reimbursement models.
- Advanced knowledge of Microsoft Office products including Word, Excel, Outlook, Access and VBA (Visual Basic for Applications.)
- MS Access and Tableau to create ad-hoc reports and design databases; competence with the process of data retrieval from data warehouses and databases; creating user-friendly forms and reports.
- Techniques and methods of data quality assessment and business intelligence data integration.
- Managed care concepts.
- Medical coding, including ICD9/ICD10, CPT, and HCPCS codes recommended.
- HEDIS certified software and SQL.
Grade: L
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