Principal Clinical Informatics Analyst (Full Time, Remote, North Carolina Based)

Alliance Health•Durham, NC

1d•$91,192 - $116,270•Remote

About The Position

The Principal Clinical Informatics Analyst supports clinical and operational goals by collecting, analyzing, and interpreting healthcare data. The role develops dashboards, reports, and data visualizations to inform decisions across departments, collaborates to ensure data accuracy, optimizes reporting tools, and improves the usability of clinical platforms. The analyst supports strategic initiatives and improves frontline staff efficiency and effectiveness. This position leads complex analytical initiatives, translates business requirements into scalable reporting solutions, and drives adoption of clinical technologies and informatics tools. The schedule is primarily remote, with no routine expectation to work in the office. Attendance at the Alliance Office for business and team meetings is required as needed. The position leads workflow and data analysis; supports the HEDIS lifecycle and related analytics; assists with clinical system implementation, integration, and configuration; manages and reports on clinical operations data; designs reports, dashboards, and visualizations; and supports regulatory compliance and audit readiness. The role serves as an NCQA HEDIS subject matter expert, provides guidance and consultation to project teams, and communicates analysis to leadership.

Requirements

Bachelor's degree in Computer Science, Engineering, Healthcare Informatics, or a related field from an accredited college or university and seven years of healthcare informatics experience supporting analytics functions in the health insurance industry; or a master's degree in one of these fields and five years of relevant experience.
Experience with NCQA Technical Specifications and the Value Set Directory.
Understanding of operational data collection requirements supporting HEDIS or similar quality programs.
Experience with the Medicaid population in relation to HEDIS measures.
Experience with medical record abstraction, quality analysis, and oversight of HEDIS-related duties, including supplemental data, prospective, and hybrid audits.
Clinical experience in a healthcare setting.
Strong presentation, collaboration, and communication skills.
Strong attention to detail, critical thinking, and problem-solving capabilities.
Demonstrated skills with computer software, spreadsheets, databases, and modeling programs.
Experience collecting user requirements and translating them into system feature enhancements.
Knowledge of state and NCQA regulatory requirements.
Ability to work independently and as part of a team.
Ability to manage multiple priorities and adapt quickly to changing priorities.
Knowledge of data analysis on databases and data sets.
Excellent written communication skills, including technical writing and document design principles.
Advanced experience with SQL.

Nice To Haves

Master's degree in Healthcare Informatics.
Certification in Health Informatics, such as Certified Health Informatics Systems Professional (CHISP).

Responsibilities

Analyze clinical workflows with departmental leadership and clinical trainers to identify opportunities for improvement and optimization.
Lead the development and maintenance of process documentation for frontline staff.
Collaborate with IT, compliance, and Quality NCQA leadership to ensure system configuration reflects workflows and workflows comply with state regulatory and NCQA requirements.
Analyze large volumes of patient and health data to identify trends and opportunities to improve patient outcomes and operational efficiency.
Serve as a subject matter expert for NCQA HEDIS measures, including Hybrid, Administrative, and ECDS measures.
Review HEDIS internal processes and plans for alignment with procedures and best practices.
Participate in developing, researching, and implementing HEDIS improvement activities; interpret and document findings; and recommend improvements to measures, processes, and reporting.
Identify system and operational issues affecting quality performance standards and escalate risks that may adversely affect HEDIS Hybrid, HEDIS Prospective, or SDVA audits.
Motivate, influence, and provide direction to staff assigned to Hybrid and NCQA projects to support project goals, deliverables, and timelines.
Interpret technical specifications, business requirements, and regulatory guidance to support accurate HEDIS measure implementation and project activities.
Provide NCQA and HEDIS guidance, training, and consultation to project teams.
Support clinical informatics functions, releases, and enhancements by helping develop business requirements with IT and clinical trainers.
Act as a liaison between clinical staff and IT, and collaborate with system configuration teams to improve system functionality.
Review, analyze, and report data from clinical operations and delegates, ensuring accuracy and timely submission to leadership.
Ensure data management practices support accuracy, patient safety, healthcare standards, and regulatory compliance.
Identify and mitigate risks involving clinical informatics systems, including interoperability and system downtime.
Acquire, analyze, evaluate, and report data using advanced SQL queries, stored procedures, MicroStrategy, and other data management tools.
Design business intelligence solutions, including dynamic and parameter-driven reports, dashboards, visualizations, and alerts.
Lead development of products that combine data from sources such as EDI files, HIE, state data, transactional systems, and data warehouses.
Support the accuracy of reports and metrics for internal and external users and ensure reporting follows external specifications.
Provide analytical and consultative support to leadership, communicating findings to guide decisions and solve business problems.
Perform geocoding using GIS software to analyze spatial statistics.
Maintain accurate and reliable clinical data systems in accordance with requirements such as NCQA and EQRO.
Facilitate CM, UM, QM, and PHM readiness for regulatory record and site audits.
Own compliance documentation, including bookmarking standards, and oversee monthly state and NCQA reporting before submission to compliance and/or Quality NCQA teams.