Job #: 1776
Title: Healthcare Operations
. Patient Engagement Reporting & Audits
a. Maintain requirements body of knowledge about patient engagement requirements and what satisfies them. Reinforce to partner and CSO teams.
b. Conduct quality assurance of results produced by vendor. Distribute to partners and CSO as needed. Conduct secure upload to NYSDOH.
c. Responsible for collecting partner data to respond to auditors.
d. Calculate and distribute dollar value of patient engagement.
II. Support PPS Analytic Operations
a. Identify data needs and gaps. Assist with evaluating sources.
b. Develop expertise in data source content, temporality, provenance, limitations, etc.
c. Communicate and reinforce rules around data sources and permissible uses of acquired data.
d. Isolate, replicate, communicate issues to data sources and partners. Track through diagnosis and resolution.
e. Communicate/teach partner staff about analytic products produced, their limitations, and how they might be able to be used.
III. PPS Analytic Systems Operations
a. Serve as SME for MAPP, Salient, DAP (claims environment) including maintaining knowledge of data refresh schedules and timing.
b. Create analyses in Salient, DAP.
c. Download and secure PHI and MCD, for additional analyses.
d. Control access to PHI and MCD as appropriate, including understanding and complying with rules around permissible acquisition, storage, and sharing.
e. Serve as SME on available reports and analyses in various systems and hold the most restricted accounts available to the PPS, e.g. RHIO cross-QE reporting account, Salient PHI download account.
f. Quality control of analytic products/reports produced from various sources and systems (MAPP, Salient, PSYCKES, DAP, Bronx RHIO, and internal).
g. Supervise junior analytic/programming staff, by maintaining and checking various logical files, designing reports, specifying data files to be used, and using SQL and other tools to confirm accuracy of report output.
h. Conduct independent analyses when needed using healthcare industry knowledge and software products like Excel, MS-SQL queries, SSRS, Tableau, Oracle SQL.
i. Oversee periodic download of PPS performance from MAPP, Salient, PSYCKES, etc for consumption, analysis and appropriate distribution.
j. Distribute analytic / report products as appropriate.
k. Oversee shredding requirement in DAP environment, and prepare affidavit when required.
l. Test RHIO deliverables, communicate errors, and track through resolution.
IV. PPS Performance Support
a. Develop and provide expertise in PPS CQM and other metrics, their dollar value, past and current performance, and workflow and measurement issues that could jeopardize PPS performance or the accurate measurement of performance.
b. Design, generate, and perform quality assurance on the production of gap lists from various systems.
c. Generate extractions for PPS performance reports from NYS sources for distribution to partners. Add value and visualizations to performance data as needed.
d. Provide data extraction, contribute to analysis and quality control to calculate P4P funds annual distribution to partners.
e. Provide data and analysis support to optimize the medical record review process across 2000 randomly sampled PPS patients by identifying and capturing data source contributions.
f. Assist with identifying data anomalies, errors, and suboptimal patterns which may affect the PPS’s CQM calculations, e.g. where claim does not match clinical data.
g. Satisfy various ad hoc report requests from various systems.