Data Analyst - Care Transformation

General Summary of Position
Supports the interdisciplinary care management team capable of furnishing an array of care coordination services to Medicare FFS beneficiaries attributed to practices that the Care Transformation Organization (CTO) supports. The Data Analyst has responsibility for data provisioning, quality assurance, database management and execution of ad hoc analysis, and advanced analytics and modeling. This includes formulating analytics to assist the team in identifying interventions or changes in programs to improve outcomes, impact on cost, quality and patient outcomes, generating innovative ideas and solutions utilizing analytic techniques and a depth of understanding data from multiple sources and increasing the speed and accuracy of the interventions and programs we implemented. Interacts with all internal and external clients to gain an understanding of specific reporting requirements. Responsible for accuracy, quality, and timeliness of data and analytics delivered by fulfilling a data steward role.
EDUCATION: Bachelors degree in Healthcare Administration, Finance, Information Technology, Business Administration or related field or a combination of equivalent experience and education. Masters degree preferred.
EXPERIENCE: 3 years experience in managed care or healthcare related organizations, with 2 years experience in data analytics to support population management programs. Experience with MS Excel, MS Access or MS SQL data bases.
LICENSE/CERT/REG: No special certification, registration or license required.
SKILLS: Project management, problem resolution, strategic and tactical planning. Ability to analyze data and then convey findings verbally and in writing in an effective manner. Identifies and proposes solutions to moderately complex problems. Skilled in healthcare payer data model, data governance, data quality, and data management.
Primary Duties and Responsibilities

  • Analyzes and interprets both clinical and financial data using knowledge of healthcare claims, including various coding guidelines (e.g., CPT, HCPCS, ICD-9 & 10-CM), healthcare finance, and regulatory agency guidelines.
  • Collaborates with multidisciplinary staff and senior management to design, implement, and evaluate outcomes for operational improvement initiatives. Analyzes and presents results to cross-functional teams to help shape clinical initiatives.
  • Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.
  • Utilize analytic solutions to measure the impact of activity on key performance and quality metrics to optimize processes and to forecast future outcomes
  • Perform quality assurance on all of data repositories to ensure quality and accuracy as well as usefulness of the reporting elements
  • Ensures that monthly and quarterly reports are prepared and delivered on a timely basis. Develops ad-hoc reports as necessary from data warehouses.
  • Leads and implements improvements, enhancements, updates, and modifications to administrative, clinical and/or financial data that enhances overall business operations and effectiveness. Maintains current knowledge of the Medicare industry, and researches potential policies, practices, and trends. Translates this knowledge into innovative reports and analyses for use by senior management.
  • Manages the design, implementation, and production of all reports; responsible for data integrity for all databases created by and for the decision support function. Accountable for problem identification and resolution with respect to accessing, accumulating, and processing information from various sources. Participates in initiatives/projects both internally and externally as assigned, ensuring compliance with corporate policies, HIPAA, HEDIS measurement, or regulatory compliance.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation and research. Our 30,000 associates and 5,400 affiliated physicians work in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest visiting nurse association in the region, and highly respected institutes dedicated to research and innovation. As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar is dedicated not only to teaching the next generation of doctors, but also to the continuing education and professional development of our whole team. MedStar Health offers diverse opportunities for career advancement and personal fulfillment.

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