This position performs analysis on medical informatic issues to meet Enterprise business needs. The position is customer facing, interacting with both internal and external customers.
The incumbent is responsible for conducting medical informatics studies. Additional responsibilities include identification of process improvement activities, providing Enterprise-wide training for various analytical software applications, and making presentations to both internal and external customers.
Nature & Scope
This position reports to the Supervisor, EBI Medical Informatics. The incumbent performs in-depth research and analysis and works closely with internal and external customers. By presenting both oral and written information to customers, the position has public relations aspect. The incumbent must work well both independently and with team members. The incumbent works closely with our technical team (EBI Informatics Support) and other staff in project development and is individually responsible for special projects and studies demanding the highest level of research and analytical skills.
Skills, Knowledge, Abilities
• Exceptional analytical and reasoning skills.
• Ability to think independently and creatively.
• Excellent interpersonal skills that include oral and written communication.
• Ability to apply knowledge of business statistics.
• Knowledge of health care delivery and financing systems.
• Ability to accept ownership of job responsibilities in a self-directed team environment.
• Superior word-processing, spreadsheet, graphics and database skills.
• A self-starter who is motivated to take the initiative in project development.
• Ability to organize and coordinate workloads for maximum efficiency.
•bility to actively listen and be receptive to feedback.
Minimum Job Requirements
1)A Graduate (Masters) degree in a health-related or business profession. Examples include Health Services Administration, Business Administration, Public Health, etc. or
A Bachelors degree AND a professional license or credential in a medical-related field. For example, a Registered Health Information Administrator (RHIA), registered nurse (RN), etc. or
A Bachelors degree AND analytical or leadership experience in risk management, underwriting, medical informatics, disease management, group account reporting, physician profiling (cost or quality) or predictive modeling.
2) Experience in disease management, outcome studies, population-based health research, or data analysis and reporting. Documentation substantiating incumbent's analysis experience, including queries or programs written to extract data and the reports produced from that data will be required for interview.
3) Experience in the application of data management and analysis tools including but not limited to, MS Access, FOCUS, SAS, or SQL. Testing for this ability may be required.
4) Experience with other PC-based software products including word processing, spreadsheet and graphics tools.
5) Experience in public speaking. Provide list of examples and audiences. Demonstration of public speaking ability may be required during interview.
6)College level statistics or equivalent experience. Testing for this ability may be required
7) Completion of the "Personal Contributor" assessment.
Progression to Analyst II
1. Experience as a Medical Informatics Analyst I in the EBI Medical Informatics Division.
2. Must have participated in a minimum of two (2) large scale projects with heavy user interfacing. Successful completion of the projects (e.g. implementation, problem resolution and user satisfaction) must be shown.
3. Demonstrated proficiency in the use (unassisted) of available tools to access and analyze data from the licensed EBI Medical Informatics software (Ingenix/IMX) and the Enterprise Business Intelligence (EBI Informatics Support Data Mart; ITS tables; medical and pharmacy claims, membership and provider tables).
Incumbent has acquired advanced job knowledge, described as follows: Incumbent is the "go to person; " i.e. the person that other members of the team rely on for assistance in accessing and interpreting data for at least one of the following significant areas of knowledge. Their knowledge and experience are such that they are capable of conducting training sessions on the subject matter .
Enterprise Data Warehouse tables-Claims, Member, Provider, GRPSummary, ITS, and Pharmacy.
- Episode Methodologies
- Risk adjustment
- Consumer transparency
- HEDIS and Quality of Care Measurement.
Progression to Analyst III
1.Meets all other qualifications in this position description and in the company Upgrade Policy and:
2.At least experience as a Medical Informatics Analyst II in the EBI Medical Informatics Division.
3.Must have participated in a minimum of three (3) large scale projects with heavy user interfacing. Successful completion of the projects (e.g. implementation, problem resolution and user satisfaction) must be shown
This position is identified as level three (3). This position must ensure the security
and confidentiality of records and information to prevent substantial harm, embarrassment,
inconvenience, or unfairness to any individual on whom information is maintained.
The integrity of information must be maintained as outlined in the company Administrative
Segregation of Duties
Segregation of duties will be used to ensure that errors or irregularities are prevented
or detected on a timely basis by employees in the normal course of business. This
position must adhere to the segregation of duties guidelines in the Administrative
PRINCIPAL ACTIVITIES OR ACCOUNTABILITIES (Essential Functions of Job)
1. Collect, organize, summarize, analyze and communicate information necessary to support managed care initiatives and systems.
2. Support and participate in the validation and improvement of Enterprise data necessary for managed care analysis and reporting both at the regional and Enterprise level.
3. Assist in identifying and implementing national benchmark measures for application to the Enterprise and its business partners.
4. Help implement new business initiatives and certify that the reporting and analytical requirements are fulfilled.
5. Stay attuned to the health care industry, particularly to innovative managed care programs and software capabilities.
6. Assist in training customers of the managed care systems in the technical aspects and analytical capabilities of those systems.
7. Employ continuous quality improvement (CQI) in all aspect of assigned responsibilities.
8. Develop ad-hoc reports and recommendations on request.
9. Participate or lead special projects.
10. Participate in the leadership of the team through empowerment.
11. Share own knowledge and experience with team members through cross-training.
12. Participate in EBI cross-functional teams.
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