Clinical Analyst MedVentive
The Clinical Analyst designs, develops, tests and implements clinical rules and related components linked to MedVentive applications and data processes. This role assists with designing, developing, modifying and testing the clinical and analytic components and methodologies of MedVentive?s applications. This position is responsible for analyzing and ensuring the data outputs of these applications are clinically and analytically accurate, logical, with actionable information that meets business needs. The Clinical Analyst is directly involved with releases of MedVentive's clinical and business intelligence products.
Primary Duties and Responsibilities
Designs, implements and tests clinical and quality rules-based functions for all MedVentive applications, e.g. HEDIS rules, Stars, IHA, PQRS, P4P program measures, and custom MedVentive rules
Validates the data output of software applications.
Performs data analysis for enhancement of the analytic components of the software.
Translates complex source information such as HEDIS, P4P, and other technical and clinical specifications into precise rules requirements.
Supports the design of reports and analytic processes for related MedVentive applications.
Depending on experience, leads or assists with severity adjustment algorithms, including DxCGs, and episodes of care
Responds to internal and external customer questions and concerns on clinical rules and the clinical and analytic applications.
Assists Support, Production, Implementation, Documentation, Software Development, Client Services and other departments with customer education on the analytic content and methodologies.
Works with MedVentive product managers, data analysts and developers to design reports and functions that incorporate rule-based results and measures.
Recommends functional improvements or corrections to MedVentive programmers and data managers.
Relies on experience and judgment to plan and accomplish goals
Performs a variety of tasks
Works under general supervision.
Other duties, as assigned.
Qualifications and Skills
Four-year degree in nursing, medical informatics or healthcare-related field
5+ years of related experience, using rule-based tools and measures with IT applications in the healthcare industry
A working knowledge of related quality standards, codes, products and industry requirements, e.g. ICD-9/10, CPT codes, HEDIS, Stars, PQRS, P4P program measures and other quality/clinical measures is required.
Must have a very detailed working knowledge of current rule standards, measures and applications, e.g. HEDIS, PQRS
Experience with risk adjusters, such as DxCG, and episodes of care, including the ETG or MEGS grouper is highly desirable.
In-depth knowledge of healthcare data and standard codes sets
Experience with designing and implementing business solutions
Experience with quality rules, risk management and working with large data sets or data warehouses
Ability to utilize SQL and/or other database query tools for analytical and testing purposes
Experience with severity-adjustment and grouper methodologies (e.g. ETGs or MEGs is very desirable.
Must be familiar with Web-based applications
Excellent verbal and written communication skills
Excellent organizational, analytical, and communication skills
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