Departmental Specialist 13 - HS Quality Performance, Payment, and Integrity Section

State of Michigan•Lansing, MI

3d•Hybrid

About The Position

The Michigan Department of Health and Human Services mission is to provide opportunities, services, and programs that promote a healthy, safe, and stable environment for residents to be self-sufficient. We are committed to ensuring a diverse workforce and a work environment whereby all employees are treated with dignity, respect and fairness. This position serves as a quality data expert within the division of contracts and quality management. The position reviews and analyzes several quality measures focused on behavioral health and provides high-level data and data system guidance, management, and coordination expertise to state systems, and local agencies. This position specializes in analyzing large amounts of data from Medicaid health plans to discover trends and patterns for policymakers, produces performance measurement/quality reports, and provides statistical consultation for local health agencies and other clients. Duties include acting as a leader in the behavioral health field for encounter reconciliation and use of encounter data in support of performance-based incentive programs, e.g., conducting the annual performance bonus and incentive scoring, and addressing statistically significant racial/ethnic disparity in behavioral health. The position fulfills ad-hoc data/research requests involving the use of encounter data, monitors encounter data quality, completeness, timeliness, and accuracy, prepares reports of data quality, as well as develops corrective action plans to address data discrepancies and data integrity issues. Validates Symmetry performance measure rates and approves Optum data upload to Care Connect 360 that is used by external stakeholders. Manage research projects, write research projects into reports, and present findings to leadership and at conferences when needed. Fills the role for the administration by providing subject matter expertise related to changes being implemented to state systems, such as the MDHHS Data Warehouse and CHAMPS. This position works closely with others, both within and outside of the Department including Pre-Paid Inpatient Health Plans (PIHPs), Community Mental Health Service Programs (CMHSPs), and Optum to provide technical assistance and information on data systems. Lastly, another function of this position is to lead research projects and serve as the bureau representative based on Administration priorities.

Requirements

Possession of a bachelor’s degree in any major
Four years of professional experience, including two years equivalent to the experienced (P11) level or one year equivalent to the advanced (12) level.

Responsibilities

Reviews and analyzes quality measures focused on behavioral health.
Provides high-level data and data system guidance, management, and coordination expertise to state systems and local agencies.
Analyzes large amounts of data from Medicaid health plans to discover trends and patterns for policymakers.
Produces performance measurement/quality reports.
Provides statistical consultation for local health agencies and other clients.
Acts as a leader in the behavioral health field for encounter reconciliation and use of encounter data in support of performance-based incentive programs.
Conducts the annual performance bonus and incentive scoring.
Addresses statistically significant racial/ethnic disparity in behavioral health.
Fulfills ad-hoc data/research requests involving the use of encounter data.
Monitors encounter data quality, completeness, timeliness, and accuracy.
Prepares reports of data quality.
Develops corrective action plans to address data discrepancies and data integrity issues.
Validates Symmetry performance measure rates and approves Optum data upload to Care Connect 360.
Manages research projects, writes research projects into reports, and presents findings to leadership and at conferences.
Provides subject matter expertise related to changes being implemented to state systems.
Works closely with PIHPs, CMHSPs, and Optum to provide technical assistance and information on data systems.
Leads research projects and serves as the bureau representative based on Administration priorities.