The Health Informatics Strategist is a key associate at Hope Network whose primary responsibilities include providing informatics expertise to develop and expand Hope Network’s position within the healthcare industry and to develop cost of care and operation models in partnership with service line leaders. This team member will utilize healthcare data to provde clinical and operational models and make improvements via any combination of higher quality, higher efficiency, and new opportunities.
ESSENTIAL FUNCTIONS AND RESPONSIBILITIES:
1. Design and perform actuarial studies related to medical care costs and trends.
2. Research and recommend systems that create efficiencies to support growth and expansion.
3. Assure compliance with regulatory agencies and accrediting bodies.
4. Generate and distribute routine reports to support actuarial calculations, pricing, and financial models.
5. Support plans for progressive steps toward organizational and programmatic consistency and sustainability; effectively communicates work plans and priorities derived from established strategic initiatives.
6. Partner with service line teams in the development of proformas and business services for growth initiatives.
7. Partner with leaders in the development of a culture that embraces change.
8. Maintains awareness of existing and emerging technology, regulatory, and market factors and assists in the development of business plans and proformas that support strategic healthcare initiatives.
9. Responsible for participating in the planning, development, implementation, and evaluation of clinical data across the system.
10. Leads in facilitating data exchanges and analyzing utilization data in coordination with health plans and other healthcare partners.
11. Collaborates with healthcare team and the Outcomes That Matter (OTM) to identify data reporting needs related to healthcare growth and expansion. Recommends systems and process to collect and analyze necessary data, and identify trends to improve organizational performance and clinical outcomes within new markets.
12. Partners with Hope Network’s Information Technology department to learn about existing challenges and develop solutions to support the evolution of the current system into the healthcare arena.
13. Works closely with Hope Network’s revenue management department, as well as fellow members of the healthcare team, to explore challenges and develop solutions to billing and collecting related to public and private payer systems.
14. Acts as an advocate for the protection of patient privacy and the security of protected health information.
15. Participates in various regulatory activities including HIPAA, Meaningful Use, and expert experience, as requested.
Educational / Talent Requirements:
1. Bachelor’s degree in a clinical specialty, information technology, or related field.
2. Advanced certification | degree in medical informatics is highly desirable.
3. Exemplary skills in building relationships with all key stakeholders.
4. Demonstrated knowledge of evidence-based medical principles and practices.
5. trong analytical and research skill.
6. Computer literacy to include expertise in Microsoft Office suite software, including Excel, Word, and PowerPoint
Experience with statistical analysis software (SPSS, R, and/or SAS)
Experience using SQL/knowledge of relational databases
Relevant AHIMA Certification (e.g. CCS, CHDA, CDIP)
7. Six or more years experience in related field.
8. SAS Experience and healthcare claims data experience required.
9. Actuary experience preferred.
Work Experience Requirements:
1. 4+ recent years of healthcare clinical informatics or clinical applications analyst experience.
2. High level of knowledge of the healthcare industry.
3. Competent decision making and strong analytical skills.