Clinical Quality Performance Data Specialist

Cape Cod Healthcare•Hyannis, MA

About The Position

The Clinical Quality Performance Data Specialist generates and analyzes data from sources including the CCHC ACO quality data warehouse, claims databases, health plan data, physician practice management systems, electronic health records, health information exchange network data, and third-party vendors. Working with PHO and CCHC data analysts, the specialist validates data and defines clinical and other standards and specifications for physician-specific and PHO-wide quality, cost, and care coordination measurement and reporting. In close coordination with the quality team, the specialist reviews reports and data to assess PHO performance against goals and identify priority opportunities for improvement. The role works with CCHC ACO leadership and the quality team to develop physician report cards that reflect organizational priorities and clinical integration plans, and uses data and reporting to support value-driven physician incentives. The specialist also assists with integration issues and support, identifies opportunities to improve integration across electronic medical records used by CCHC PHO physician practices, clarifies performance reports and documentation, and performs or supports routine chart abstraction for payer audits and internal performance measures. The position maintains collaborative relationships with physicians, practice staff, PO Managers, CCHC ACO staff, and health plans, and performs other duties as opportunities arise and are assigned.

Requirements

Three to five years of experience in active use of healthcare informatics.
Accuracy and attention to detail.
Ability to collect and interpret clinical information from diverse sources and summarize it in a meaningful, actionable manner that supports performance improvement.
Strong interpersonal skills and ability to interact positively with a wide range of constituents.
Excellent written and verbal communication skills.
Ability to present information to small and, at times, large audiences.
Strong organizational and project management skills, including developing project parameters, goals, and timelines and measuring outcomes.
Ability to maintain confidentiality and handle information confidentially according to policy.
Ability to function effectively in an ever-changing environment, meet deadlines, and reprioritize as necessary.
Ability to work independently, within a team, and in a multidimensional environment.
Creative, flexible, self-motivated, and professional, with sound judgment and the ability to plan and initiate activities consistent with achieving service excellence.
Poise, judgment, and trustworthiness to represent CCHC ACO to internal and external groups.

Nice To Haves

Bachelor’s degree preferred, or an equivalent combination of experience and education.
Nursing degree is a plus.
Knowledge and proficiency with analytic and clinical systems, including MS Office Suite (Excel, Word, and PowerPoint), EMRs, SQL, and relational databases.

Responsibilities

Generate and analyze data from the CCHC ACO quality data warehouse, claims databases, health plan data, physician practice management systems, electronic health records, health information exchange network data, and third-party vendors.
Work with PHO and CCHC data analysts to validate data and define standards and specifications for measuring and reporting physician-specific and PHO-wide quality, cost, and care coordination data.
Review reports and data with the quality team to assess PHO performance against goals and identify priority areas for improvement.
Work with CCHC ACO leadership and the quality team to develop physician report cards reflecting organizational priorities and clinical integration plans.
Use data and reporting to support the development of value-driven physician incentives.
Assist with integration issues and support, and identify opportunities to improve integration among electronic medical records used by CCHC PHO physician practices.
Provide clarification and support regarding performance-related reports and accompanying documentation.
Perform and support routine chart abstraction activities related to payer audits and internal performance measures.
Maintain collaborative team relationships with physicians, physician practice staff, PO Managers, CCHC ACO staff, and health plans.
Perform other duties as new opportunities arise and are assigned.