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Req. No

91548

Job Title

Program Manager Clinical Analytics

Market

CHRISTUS System Office

Category

Analytics and Reporting

Facility

CHRISTUS Corp Irving Offices 919 and 909 Buildings

Address

919 Hidden Ridge
Irving, TX  75038
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Type

FULL TIME

Program Manager Clinical Analytics Job in Irving

Summary:

CHRISTUS Health Plan is looking to hire a Program Manager of Clinical Analytics to develop a team that focuses and executes on the technical aspects related to the HEDIS domain. As the Program Manager of Clinical Analytics, you are expected to have deep subject matter expertise on all things HEDIS related, as well as the operations, design, and technical aspects of our clinical and medical management programs. You will act as a key decision maker across the Quality technical team at CHRISTUS and be responsible for serving as the data SME focusing on using data to identify opportunities, drive improvement, and maintain clinical quality outcomes. This position will support accurate and timely data issue resolution, along with monitoring and tracking deliverables in support of reporting requirements for internal partners and external stakeholders. You will excel in leading organizational change management, as well as managing cross-functional teams in the development, planning, and execution of programs that drive measurable improvements.

  • Gather, analyze, and validate data from internal and external sources to identify data characteristics, needs, and problems
  • Analyze claim and supplemental data to identify specific opportunities to improve the quality of care our members receive and/or our ability to demonstrate those quality results in HEDIS reporting
  • Analyze claim and supplemental data to identify specific opportunities to improve cost and utilization results through medical management programs
  • Define the core competencies/capabilities that distinguish our quality metrics in the marketplace
  • Document and communicate technical specifications to applicable stakeholders and make updates to processes as needed
  • Track vendor performance to service level agreements (SLA)
  • Subject matter expert on our HEDIS software platforms
  • Analyze, review, and trend all HEDIS, medical management, and clinical related data 
  • Support short and long-term operational/strategic business activities through analysis 
  • Develop recommended business solutions through research and analysis of data and business processes and implement them when appropriate 
  • Responsible for leading/developing a functional technical team
  • Work with minimal guidance; seek guidance on only the most complex tasks
  • Self-starter that demonstrates the ability to trailblaze a developing team 
  • Assess and interpret customer needs and requirements 
  • Identify solutions to non-standard requests and problems 
  • Provide explanations and information to internal/external customers on issues 
  • Technical skill is required as this position is a mix of business and technical skills 

Requirements:

  • Bachelor’s degree or equivalent work experience
  • 3+ years of experience with healthcare claims analysis
  • 3+ years of experience; skilled in reading and writing moderate to complex SQL commands and accurately assessing results
  • Experience with analyzing HEDIS metrics or Functional SME for HEDIS reporting
  • Experience with HEDIS vendor software a plus or experience with HEDIS reporting using other tools SSIS ETL development
  • Experience gathering requirements from the client/business and documenting
  • Experience with process improvement, workflow, benchmarking and / or evaluation of business processes
  • Project Management experience a plus
  • Intermediate level of proficiency with PC based software programs and automated database management systems required (Excel, Access, PowerPoint)
  • Working knowledge of relational databases, database structures
  • Ability to write clearly composed documentation for business requirements documentation as well as information that will be distributed to auditors

Work Type: 

Full Time


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Program Manager Clinical Analytics