Description

Clinical Informatics Analyst

JOB SUMMARY

The Clinical Informatics Analyst will serve as consultant and collaborates closely with health plan departments and leadership teams . The coordinator supports the use of health information technology by serving as first line support to end-users across the health plan . The scope includes:

• health services platform training on authorization, case management services, population health, and appeals/grievances module navigation, field population, and use

• documentation of processes, workflows, issues, projects,

• authorization required components verification,

• authorization entry,

• claims-to-authorization matching for claims adjudication,

• system configuration and application cross-walking,

• clinical detail search and documentation,

• medical billing and coding review/comparison,

• regulatory and contractual report creation and data validation,

• the transfer, receipt, and access of clinical information for providers, contracted partners, and members,

• health services projects, implementations, and improvements, enhancements

• health care systems and research and resolution of clinical information issues,

• data query and analysis, volume assessment, and presentation

• documentation, tracking, and trending processes, workflows, projects, activities, issues and resolutions.

The analyst will integrate principles of human factors, clinical informatics, change management and clinical transformation.

ESSENTIAL FUNCTIONS OF THE ROLE

Develops knowledge of Baylor Scott & White Health applications, policies, procedures and processes to provide ongoing end-user support and training to staff.

Develops foundation level knowledge of health information technology and the application/impact to the health plan setting.

Identifies, documents issues/problems and works with appropriate health plan departments and contracted vendors on solutions and resolutions .

Tracks issues from identification through resolution and follows up with customers during and after delivery of services to ensure needs have been met.

Acts as individual contributor to project success and completes assigned tasks timely.

Establish and maintain effective relationships in the health plan setting. Communicates and distributes prepared materials for changes that affect end-users.

Develops understanding of roles and responsibilities for informatics, clinicians, and analysts. Attends meetings and governance councils, as assigned.

KEY SUCCESS FACTORS

Excellent communication (verbal and written), interpersonal and organizational skills.

Strong critical thinking and problem-solving skills.

Affinity for technology-human interaction.

Proficient in Microsoft Office suite of applications.

Health care setting 1 Year or greater, preferred

SQL knowledge and/use, preferred

Medical billing and coding, ICD-10, HCPCS, CPT, health services authorization and claims knowledge & understanding

Power BI

HealthRules Payer knowledge/use

GuidingCare knowledge/use

BENEFITS

Our competitive benefits package includes the following
- Immediate eligibility for health and welfare benefits
- 401(k) savings plan with dollar-for-dollar match up to 5%
- Tuition Reimbursement
- PTO accrual beginning Day 1
Note: Benefits may vary based upon position type and/or level

QUALIFICATIONS

- EDUCATION - Bachelor's or 4 years of work experience above the minimum qualification

- EXPERIENCE - Less than 1 Year of Experience