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Clinical Analyst

Company: Bureau Of Tenncare
Location: Nashville
Posted on: November 11, 2018

Job Description:

Background-- TennCare is Tennessee's Medicaid program that provides health insurance coverage for 1.4 million low income children, pregnant women, disabled adults, and adult caretakers of children.-- TennCare currently covers one out of every five Tennesseans and 50% of all Tennessee births, with an annual budget of $11 billion.-- TennCare partners with its managed care organizations (MCOs) to provide high quality integrated physical, behavioral, and long term care to its members. Mission & Team OUR MISSION TennCare's mission is to support a healthier Tennessee by improving lives through high-quality cost effective care. TennCare has been a leader in innovation through clinical care models and delivery system payment reform while promoting the delivery of high quality services within a sustainable budget. TennCare's Behavioral Health Operations office sits at the forefront of this mission to support behavioral health clinical quality and operations, federal and state policy, and strategic innovation for the agency. The Behavioral Health Clinical Analytics Director is an integral position within Behavioral Health Operations that is responsible for monitoring, reporting, and helping to design innovative strategies focused on improving behavioral health clinical quality and behavioral health outcomes. All over the country health policy experts are figuring out how to improve the quality of health care while restraining the cost increases. Tennessee is now a leader in this area because of the Tennessee Health Care Innovation Initiative. We are rapidly changing the way that health care is paid in the state, and working with the largest health care purchasers and providers to design and implement our strategies. Tennessee Health Link and Behavioral Health Episodes of Care are two components of the Tennessee Health Care Innovation Initiative. The Clinical Analyst plays a strategic role in continuing the development of TennCare's behavioral health initiatives focused on improving clinical care and outcomes for TennCare members. OUR TEAM The Clinical Analyst works within the Behavioral Health Operations team; however, will be expected collaborate frequently with other departments and/or teams. The Clinical Analyst will support projects and initiatives within these TennCare divisions: Office of the Chief Medical OfficerManaged Care OperationsQuality OversightStrategic Planning and InnovationHealth Care InformaticseHealth Externally, the Clinical Analyst works closely with TennCare's contracted Managed Care Organizations and will provide oversight of behavioral health quality performance and data reporting for TennCare providers and members. The Clinical Analyst will be a member on the Behavioral Health Operations team reporting directly to the Behavioral Health Operations Director. Primary Responsibilities will include the following: Provide oversight, analyses, and strategies for the following components related to the Tennessee Health Link Program to help drive and improve quality:Health Link quality and efficiency metricsManaged Care Organization Health Link Performance reportsHealth Link Value-Based Payment processHealth Link Detailed Business RequirementsTennessee Health Link Engagement Evaluations (provider audits)Collaboration with Quality Oversight to develop innovative approaches and strategies to improve quality of careCollaboration with eHealth to use and become the business owner of the Tennessee Health Link Dashboard to create reports for Executive LeadershipCollaborate with our internal HealthCare Informatics team on strategies to streamline and improve our TennCare behavioral health reports for various stakeholdersCollaborate and assist the Strategic Planning and Innovation, Quality Oversight, Managed Care Operations, and the Office of the Chief Medical Officer departments in providing oversight, analyses, strategies, and new payment reform models for the following components related to the following TennCare Programs and Initiatives to help drive and improve quality:Behavioral Health Episodes of CareMedication Assisted Treatment quality metrics and reportsBehavioral Health Value-Based Payment InitiativesBehavioral Health Managed Care Organizations' Utilization and Performance ReportsSpecial projects as assigned by the Behavioral Health Operations Director. Minimum Qualifications A master's degree in public health, statistics, applied statistics, social or behavioral sciences, health sciences, business, business administration, or public policy and 2+ years full time professional work developing research methodology and/or directing statistical researchStrong computer skills including mastery of Microsoft Office applications such as Excel, Access, Word, and Power Point, as well as statistical software applicationsExcellent interpersonal, oral, and written communication skillsStrong math skillsStatistical and analytical experienceAbility to understand and explain complex processesStrong organizational skills, including the ability to prioritize, multi-task and manage workload to meet specific timeframes and deadlinesAbility to produce and summarize routine and ad hoc reports with short notice -- Desirable Qualifications Experience in health care delivery and administration (hospital, physician practice, mental health agency, etc.) or state/federal health agency and policiesExperience in managed care and/or quality improvement and/or HEDISExperience with population health or value-based payment reformsExperience in data analysis, manipulation and interpretation, preferably in SQL, Tableau, SAS, R, or similarStrong understanding and utilization of MS Excel; Excel Add-ins (PowerPivot and Power Query) Salary/Range:-- Compensation and benefits arrangements are competitive and will be commensurate with the selected candidate's experience and responsibilities of this position.-- -- Pursuant to the State of Tennessee's Workplace Discrimination and Harassment policy, the State is firmly committed to the principle of fair and equal employment opportunities for its citizens and strives to protect the rights and opportunities of all people to seek, obtain, and hold employment without being subjected to illegal discrimination and harassment in the workplace. It is the State's policy to provide an environment free of discrimination and harassment of an individual because of that person's race, color, national origin, age (40 and over), sex, pregnancy, religion, creed, disability, veteran's status or any other category protected by state and/or federal civil rights laws. The Tennessean.Category: Healthcare, Keywords: Medical Records Analyst

Keywords: Bureau Of Tenncare, Nashville , Clinical Analyst, Healthcare , Nashville, Tennessee

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