This is a technical position responsible for the development and maintenance of the information reporting systems for Practice Management Unit. This involves the development of SSRS, SQL/SSMS reports, Power BI Dashboards, required documents, development of TP and PIHP required reporting, and input into long range planning for the development, implementation, evaluation, and enhancement of value-based purchasing arrangements and performance improvement projects. This position is also responsible for assuring compliance with DMH and DMA contract requirements and will assist in the development of quality measurement, focusing on outcome-based metrics. This position will assist the organization in the adoption of innovative and new technologies that can improve the health and well-being of our members with a focus on improving discrete health outcomes. This position is responsible for working with a multi-disciplinarian team to evaluate the efficacy of value based reimbursement (VBR) strategies employed within the organization. This position is responsible for creating measurement methodology and for determining correct measures to be used based on desired outcomes of specific value based reimbursement programs. Employee will be responsible for the management of all aspects of reporting including SSRS, SSMS, SSIS, Power BI, and third-party solutions.
DESCRIPTION OF ESSENTIAL RESPONSIBILITIES AND DUTIES:
Works with various databases to collect, analyze and report data related to provider performance, statistical data on populations, disabilities, and cultural factors, and financial impact of value-based purchasing.
Design, Develop and Maintain Practice Management and/or Network Management reports and pertinent Reporting platforms, including SQL/SSMS, Power BI, and third-party solutions.
Coordinate with Informatics and Data Science staff, as needed.
Uses various analytical programs such as R or Python to support reporting functionality.
Plan, coordinate and implement security measures to safeguard information in VBP files against accidental or unauthorized damage, modification or disclosure.
Develop methods for integrating diverse products so they work properly together, such as customizing outside data sources to fit specific needs in Practice Management.
Implements business rules via stored procedures, middleware, or other technologies.
Develop data reference and workflow documents for documentation purposes and operations in Practice Management.
Will assist with creating reports, data mining and data management.
Ability to work unsupervised.
Discovers and contributes to the development, implementation, and maintenance of data associated with value-based purchasing initiatives.
Effective communication and documentation skills.
Develops analytical reports to summarize and interpret results, to identify patterns and trends in data, and to track various metrics related to key performance and clinical outcome measures.
Responsible for the validation of data collected specifically by Practice Management, ensuring data integrity of identified data. Works closely with colleagues to investigate and reconcile data related discrepancies.
Maintains schedule of external reporting per contracts and internal reporting to ensure all reports are submitted within assigned deadlines to avoid possible penalties or plans of correction.
Assists with the development and presentation of various internal/external trainings related to Practice Management data analysis and the benefits of data informed decision making.
Provides technical assistance to Practice Management staff related to provider performance, data, performance measures, and the financial impact of value-based purchasing.
Provides technical assistance to other Trillium department staff or provider agencies regarding Practice Management analytics and reporting.
Presents Practice Management data reports to providers and external stakeholders, as directed.
Other duties as assigned.
III. KNOWLEDGES, SKILLS, AND ABILITIES: Knowledge:
MS SQL Server operating systems knowledge
Networking, data communications, micro-computers, Intel based servers, and related equipment are necessary
Problem solving skills and effective communication skills
Statistical knowledge
Implementing operational automation using scripts
Knowledge of Microsoft Power BI or comparable Analytics software
Writing SQL scripts and stored procedures
Strong knowledge of data collection, data analysis, reporting and use of multiple data bases.
Strong knowledge of state and federal rules, requirements and practices related to the service continuum in North Carolina.
Strong knowledge of evidenced-based practices and value-based purchasing models is imperative
Skills and Abilities:
Translate and communicate highly technical concepts to both technical personnel, non-IT business users, and Network Providers
Organize, prioritize, and follow complex and/or detailed technical procedures
Work independently and perform job with minimal supervision
Demonstrated skill in preparing implementation plans to multiple platforms
Diagnose software problems
Keep up with quickly changing technology as necessary
Problem Solving and Conflict Resolution skills are essential.
DECISION MAKING/CONSEQUENCES OF ERROR:
Consequences of error could include substantial financial liability for the organization; incorrect information being provided to management may result in wrong decisions being made; inaccurate data could result in problems with local, state, and federal agencies; inaccuracy in technical decision-making could result in costly downtime of the organization’s I.T. Systems or even loss of data and information that the organization is dependent upon for efficient and successful operation.
MINIMUM EDUCATION:
Associate’s degree Major: Information Technology/MIS, Mathematics (Actuarial/Statistics), Data Analytics, Engineering Sciences, Business, Healthcare Administration, or Human Service Field. Applicable certification(s) may be substituted to equivalent degree requirements. Two year degree requires certification.
MINIMUM EXPERIENCE:
Required Experience: Minimum of four (4) years’ experience in any of the following areas: Information Technology / MIS, Mathematics (Actuarial/ Statistics), Data Analytics, Engineering Sciences, Business, Healthcare Administration, Human Service field, healthcare claims environment, reporting development, n-tier and web-based system development or support with strong technical knowledge in the specialized areas of application system programming, including software tools such as: SQL Server 2008 R2 or above, SQL, Oracle, NoSQL, MySQL, TFS (Team Foundation Server), Microsoft IIS and Microsoft .NET framework2.0 or above , Source Control, SSRS, SSIS, SSAS, SSMS, Visual Studio BIDS, Visual Studio 2008 or above, C# or equivalent of higher education or higher education/experience.
Preferred Experience: (if applicable)
Recent Experience with SQL database management or report development
SPSS, SPSS-X, R, Python, or similar software and/or Microsoft Power BI
Standard coding and structures like CPT, ICD, etc.
Managed care organization/environment or clinical setting
Working knowledge of the MH/SU/IDD service array and benefits offered by various funding sources and provided through a network of providers preferred.
Working knowledge of the HCP-LAN APM Framework.
VII. PROFESSIONAL LICENSE OR CERTIFICATION REQUIRED/PREFERRED: Preferred: (if applicable) Applicable certification(s) including Microsoft data systems certifications CSTP, ISTQB, ASTQB, MTA, MCSA, MCSD, MCSE, ITIL v3, Power BI, as well as INFORMS, IIBA, AWS, Azure, CSPA, Certified Machine Learning – Specialty (AWS), Predictive Analytics Certificate (SOA), and/or CPHIMS/CAHIMS or equivalent certifications will be accepted.
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