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Senior Clinical Informatics Specialist

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West Hartford, CT

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SCIOHealth Analytics is seeking an experienced and self-motivated Senior ClinicalnInformatics Specialist. This is a home office opportunity. This role serves as the seniornclinical team member, working closely with the Director of Clinical Analyticsnto develop and enhance clinical and claims data-based content and solutionsnused within **MEMBERS ONLY**SIGN UP NOW***.u00b4s systems, models and reports. The incumbentnworks closely with other team members within Clinical Analytics area helping tonsupervise updating of system-wide clinical, utilization and quality-relatedncontent necessary supporting existing systems, models and applications.Along with the Director, the incumbent worksncollaboratively with Advanced Analytics, Product Development and other SCIO departmentsnon the development of new initiatives as well the enhancement of existingncapabilities. KeynDuties and Responsibilities: Identify opportunities fornintegrating evidence-based and best practice standards into a singlendefinitional development platform such as CDM as well as other softwarencapabilities that would enhance departmental efficiency and effectiveness.This includes but is not limited to:Automatingnwhere possible manual research and documentation efforts, reducing redundancynas well as identifying and eliminating process points at which errors are mostnlikely to occur Providing more efficient ways ofntracking definitional versions as well as code changes and informationalnsources at the condition, sub-condition, measure and fact levels, etc. Working with the Director to identifynways in which Clinical Analytics can support key analytic initiatives withinnthe company, not only those tied to Health Analytics, but also those tied tonReimbursement Optimization new approaches Establishing optimal definitionalnworkflow process as well as identification and sourcing for evidence-based andnbest practice standards Create and document quality clinicalncontent within SCIOVantage, SCIOMine and other SCIO applications through thenuse of standard code sets, i.e. ICD-9/ICD-10, CPT, HCPCS, LOINCu00b4ss andnNDCu00b4ss.Isnable to accurately and reliably create & update condition-related contentnin CDM for downstream configuration by Product DevelopmentIsnable to accurately and reliably create & update fact-related content in CDMnfor downstream configuration by Product DevelopmentIsnable to accurately and reliably create and update quality-related measurencontent in CDM for downstream configuration by Product DevelopmentIsnable to accurately map all provider specialty, type of service and place of servicenvalues to CMS standard and direct/quality control the Chennai team in suchnactivities Works both independently andneffectively, as well as collaboratively with others within the ClinicalnAnalytics, Advanced Analytics, Product Development and other areas as needed innthe testing and analysis of application results.This applies to whenever applications havenbeen initially created or updated within the User Acceptance Testing Phase Is able to apply knowledge base innunderstanding diseases and disease processes, and how care is rendered and paidnfor, if ad hoc definitional projects are required. Will perform other duties asnassigned Comply with all SCIO Handbookpolicies and procedures - Comply with HIPAAnand other regulations regarding confidentiality of information Supervisory Responsibilities: Mayninclude direct supervision of the Chennai Clinical Team & quality controlnof their work Knowledgenand Skills: Hasnan excellent knowledge of all code sets and their use, and is able to qualityncontrol oneu00b4ss own and peersu00b4s definitional content Hasnan advanced knowledge base in understanding diseases and disease processes, andnhow care is rendered and paid for.Has atnleast good knowledge of predictive modeling, claims adjudication and risknadjustment principles Hasna working knowledge of claims data.Understanding of EMR data and its configuration is a plus Hasnan advanced knowledge of quality of care metrics using NCQA/HEDIS and othernindustry-recognized standards of care and their deployment.Also has a good to excellent knowledge ofnindustry standard utilization and cost metrics Understandsnhow applications and models are structured and how Clinical Analyticsu00b4s contributionsnmust similarly be structured for other departmentsu00b4s use Developsnand implements methodology, practice and related content and policiesnaddressing data utilization to aid in how quality and performance are measured,nmonitored, analyzed and continually improved to enhance patient care, reducenrisk and reduce costs Maintainsnknowledge of healthcare industry trends related to quality and data management,nmeasurement methodologies, performance improvement, and the relationshipnbetween reimbursement and performance, and the public reporting of clinicalnperformance data Possessesnearned proficiency and experience Qualifications: Bachelors and 8- 12 yearsu00b4snexperience or equivalent combinations 5 years of experience using EMRnand/or claims systems and knowledge of electronic data systems andnsophisticated data analysis in support of system-wide clinical qualitynimprovement & cost measurement activities. Demonstrated ability to use andncommunicatefindings and theirndeployment and/or 5 years of experience in healthcarenquality with demonstrated ability to utilize and manipulate data to design andnaid in the implementation of product improvement activities 5 years of experience, serving as anclinically-oriented system and/or business process improvement expert,ncoordinating the functional process responsibilities including creation and/ornmaintenance of clinically-oriented code tables Baccalaureate degree required withnMasteru00b4ss in business, nursing, healthcare administration, or a relatedndiscipline preferredu00a0 Working Conditions: Normal office working conditionsnwith the absence of disagreeable elements.

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