Director Population Health Analytics
– US Remote
We are hospitals and affiliated medical groups, working closely together for the benefit of every person who comes to us for care.
We build comprehensive networks of quality healthcare services that are designed to offer our patients highly coordinated, personalized care and help them live healthier lives.
Through collaboration, we strive to provide all of our patients and medical group members with the quality, affordable healthcare they need and deserve.
Reporting to CRC President, and dotted reporting to the regional CRC leaders, the Director of Population Health Analytics will manage the HealtheIntent platform and other data sources to deliver high quality financial, clinical, utilization and operational reports and information using industry standard principles.
The Director of Population Health Analytics will operate across a matrixed organization and collaborate closely with all areas of the business, especially Operations, Clinical, Quality, Finance, Managed Care Contracting, Network Operations and Medical & Care Management; serving all CRC markets.
Job Responsibilities/Duties
Provides insights and analytics by overseeing, managing and leveraging Cerner’s HealtheIntent and data-mining quantitative skillsets (on structured & non-structured financial & clinical data) to produce various reports to support Population Health decision-making and improve utilization and cost performance in value based, risk and capitated/delegated contracts.
Leads the development, delivery and management of utilization reporting, service retention reporting, STAR ratings, cost accounting, budgeting, service line reporting, physician level reporting, quality measures (HEDIS, CAHPS, HCAHPS, etc.), benchmarking reports from the HealtheIntent platform and other data sources that are both standard and ad hoc for operators to improve clinical and operational performance.
Develops pro forma projections, financial analysis and recommendations for provider, hospitals, and health plan contract negotiations in addition to supporting medical cost management initiatives, and directional business development opportunities.
Qualifications
Minimum Education: Bachelor’s degree in Finance, Analytics, Healthcare Administration, Health Economics or related field.
Minimum Experience: Five (5) years of progressive financial & decision analysis leadership experience in managed healthcare.
Minimum of three (3) years of claims, eligibility, HCC/RAF coding, quality measures reporting, financial analysis, data structuring & mining, and supervision experience in the managed health care environment.
Three to five (3-5) years of experience with SQL, reporting writings, EHRs and claims systems data.
Req.
Certification/Licensure: None.
Employee Value Proposition
Prospect Medical Holdings, Inc., is guided by a diverse and highly experienced leadership core.
This group maintains the vision that has made Prospect a needed difference-maker in the lives of so many patients today, and many executives contribute to our continued efforts.
As a member of our highly effective team of professionals, benefit eligible positions will receive: