Partners Healthcare System Somerville , MA 02143
Posted 2 months ago
This is a hybrid role requiring an onsite presence in the office in Somerville at least once every other month.
Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world's leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage.
Our work centers on creating an exceptional member experience - a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated.
We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more.
The Clinical Data Analytics Manager reports to the Senior Clinical Operations Manager to support the implementation of operational excellence and continuous improvement strategies within the Clinical department. The Clinical Data Analytics Manager is responsible for the retrieval and analysis of data to review Clinical department operations and meet regulatory requirements.
Principal Duties and Responsibilities:
Support performance management for the clinical department
Support identification, refinement, and continued monitoring of a focused set of key performance indicators to monitor operations across the clinical department including utilization management, quality, appeals and grievances, population health and pharmacy
Establish and periodically refresh targets that support company goals, adhere to regulations, and align with industry standards
Develop dashboards for Clinical and cross-functional teams and leadership audiences to periodically monitor performance measures and targets
Monitor clinical department's progress toward achieving performance incentives; establish/attend periodic review meetings with impacted stakeholders (e.g., sales, contracting, etc.)
Escalate performance issues to process owners and/or leadership, as appropriate
Develop, refine, and maintain clinical department reports
Assist with the acquisition and analysis of data to support required reporting for MassHealth Quality Improvement Goals, NCQA, and for program evaluations
Conduct periodic inventory of Power BI reports; identify data/reports that should be created, updated, and/or retired in accordance with business needs
Work to improve visualization of current reports using existing tools and new tools as they become available
Gather and document specifications required to facilitate reports for production
Serve as an expert, "super-user" of available data sources (e.g., Data Warehouse, Provider Dashboard) and predictive modeling tools
Facilitate data-driven decision-making through robust analyses and clear data visualization
In collaboration with the Senior Clinical Operations Manager, perform trend analysis to identify risk and assess potential opportunities for improvement within department operations
Evaluate and track the success of interventions and quality improvement initiatives, completing quantitative and qualitative analysis to support program objectives
Develop scenario modeling using claims-based, clinical, and financial data and acquiring data in cooperation with service team leaders and support staff
Perform ad hoc analysis to assess the impact on utilization and costs of various clinical management initiatives
Interpret and summarize data using charts, graphics, and text to ensure key findings are appropriately communicated in presentations and other methods
Act as lead analyst for the clinical department
Achieve and maintain awareness of activities of other clinical analysts
Coordinate with other clinical analysts to ensure consistency and best practices
Assist business owners and analysts within population health, utilization and care management, and Quality with critical analytics needs
Escalate risks, gaps, and barriers to achieving technical and/or data needs
Promote cross-training of analysts within clinical department
Support training of staff/management on key technical capabilities, as needed
Assist leadership in scoping future analytic needs
Foster collaborative relationships with customers and stakeholders
Collaborate with Mass General Brigham Medical Economics and Provider Network Management and other internal areas on special projects
Develop effective relationships with leaders and staff in the clinical department and the Health Plan
Collaborate with administrative, clinical leaders and other key stakeholders to support Clinical programs and performance improvement initiatives, understanding structured and unstructured data to determine insights and implement evidence-based interventions across stakeholder groups
Present ideas, updates, findings, reports, recommendations, data, and analysis to various audiences to build consensus on program initiatives
Use Mass General Brigham healthcare values to govern decisions, actions, and behaviors
Work with Senior Clinical Operations Manager on special projects and high-profile initiatives
Qualifications:
Bachelor's Degree in a related field (e.g., statistics, mathematics, computer science, business administration, or a related discipline. etc.). Or the equivalent combination of training and experience, plus 5-7 years of related experience.
Masters degree preferred.
3-5 years in data analytics or directly related field (e.g., Clinical Informatics). Managed care and health care experience preferred.
Expert in data analysis and visualization
Experience with data extraction, data warehouse and data mining, data visualization, relational database systems, document management, and business planning
Experience with medical, behavioral health, and pharmacy claims and associated terminology preferred
Expert in SQL server
Proficient with MS Office Suite, including Power BI, PowerPoint, Excel, and SharePoint
Experience presenting to senior leaders.
Skills/Abilities/Competencies:
Demonstrate Mass General Brigham Health Plan's core brand principles of always listening, challenging conventions, and providing value
Strong analytical and problem-solving ability, high ownership of work product value, and commitment to driving reliable results
Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience; strong executive presence, presentation, and communication skills; strong verbal, active listening, and written communication skills required.
Ability to provide consultation to constituents to identify their needs
Must be extremely detail-oriented and draw well-thought-out conclusions
Ability to work independently, and as part of a team
Collaborates well with others
Accountable for delivering high-quality work
Strong aptitude for technology-based solutions
Bring fresh ideas forward by listening to and working with employees and the people we serve
Respects the talent and unique contribution of every individual, culture, and ethnic group and treats all people in a fair and equitable manner
Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback
Excellent interpersonal skills, including the ability to influence others at all levels of an organization
Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback
Unquestionable integrity
Supervisory Responsibilities:
Partners Healthcare System