Clinical Analytics and Accreditation Analyst (RN) Job
Yoh has a direct-hire opportunity for a Senior Clinical Analytics and Accreditation Analyst (RN) to join our client in Cleveland, OH. Job Overview: The Senior Analyst is responsible for the investigation of complex clinical issues, designing data requests, utilizing system applications to obtain or analyze data, and researching policy, benchmarks and clinical literature. This position also analyzes medical trends, makes recommendations, and composes and presents reports to management. The Analyst is responsible for oversight of accreditation standards and works with various departments within the client to ensure compliance. He / she actively participates in various committees, monitors performance guarantees, and reports on client's predictive clinical outcomes. May present report to external customers. This position also fulfills a leadership role on various activities or projects. Job Responsibilities: - Acts as an expert resource to internal customers with regard to the use and interpretation of complex clinical data. - Conducts effectiveness studies of various Care Management functions. These studies include qualitative and quantitative analyses of available data, a detailed review of current process flows and collaboration with the applicable functional management team. - The analyst will provide recommendations to improve effectiveness and efficiency, and will collaborate with the functional management team to conduct a barrier analysis and implement an action plan for improvement, when applicable. - Interprets data / reports to trend client medical utilization, clinical outcomes and determine financial impact. - Serves as a resource to management and other areas of the company to assist in obtaining client data, understanding clinical information and outcomes. - Tracks Client Performance Guarantees. - Interprets standards published by national accrediting bodies, gathers and documents supporting evidence demonstrating compliance with said standards. Transmits documentation to agency's online tool. - Acts as an expert resource to internal customers with regard to the interpretation and implementation of accreditation standards. - Collaborates with external delegates with regard to accreditation standard oversight. Works with accrediting agencies during onsite reviews. - Supports and collaborates with internal and external customers regarding the analysis and application of clinical output from predictive modeling resources and HEDIS results. May present findings to external customers as requested. - Performs ad hoc data analysis to provide information to be used in high level negotiations, major business proposals and forecasting as requested by management. - Represents the department through participation in appropriate committees or teams. Assumes a leadership role on various activities or projects as assigned by management. Job Qualifications: - Masters in Clinical Informatics, Public Health, Statistics, Business, etc. with an undergraduate degree in Nursing, Biology or a related field. - Five (5) years clinical experience or five years related analytical experience. - Certification in Quality or related field by a nationally recognized professional association is desired. - Progressive experience in various aspects of the organization, including claims processing, provider contracting, benefits, medical policy and reimbursement. - Strong interpersonal skills with demonstrated leadership skills. - Strong verbal and written communication skills. - Demonstrated analytical and organizational skills. - Knowledge with medical terminology / coding. - Excellent computer skills including Access, Excel and statistical software. - Performs work in an office environment. - Some travel is required. Discover all that's possible with Yoh. Apply now. Recruiter: Jennifer Gillman Phone Number: 215-299-2458 Yoh is a professional staffing provider with over 70 years of experience in the short and long-term staffing services industry; visit our website to learn more about our company. If you are seeking workforce solutions in the IT sector, see our comprehensive IT Staffing Resources . Yoh, a Day & Zimmermann company, is an Equal Opportunity Employer, M/F/D/V. Ref: 1002246 SFSF: HC
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