Value-Based Care Informatics Analyst

Education and Work Experience:

• Bachelor's Degree in Health Informatics, Public Health, Healthcare Administration, Information Systems, Health Information Management, Data Science, or a related field: Required
• Two years' experience in claims-analytics, other national healthcare analytics (i.e. HEDIS reporting), informatics, data analysis, or a related field: Required
• Relevant internship, academic projects, or relevant practicum experience: Required
• Previous experience with NCQA HEDIS reporting and line of business comparators: Required

Licenses/Certifications:

• Epic application certifications based on organizational needs: Preferred

Essential Functions:

• Develop, run, and maintain standard reports and dashboards using VBC reporting tools in Epic and other enterprise analytics platforms. Support routine and ad hoc reporting requests for value-based care and quality initiatives. Monitor scheduled reports and ensure timely execution and distribution. Maintain documentation of report logic, metric definitions, and data sources. Assist with dashboard refreshes, data extracts, and visualizations as directed. Perform initial validation checks on analytics outputs to confirm completeness and reasonableness. Integrate clinical and claims-based reporting to ensure timely point of service reports for intervention. Also, provide trend analysis using standard hybrid methodology, benchmarks, and prior period performance. Determine “number needed to treat” to ensure goal achievement. Document validation results and escalate discrepancies to senior analysts, VBC team and the Informatics Lead. Support execution of test plans for new or enhanced reporting solutions with particular attention to data integrity. Assist in maintaining audit and validation documentation to support regulatory and payer requirements.
• Maintain and update data dictionaries, business rules, and metric definition documentation. Assist with tracking changes to data sources, transformations, and adherence to standard metric logic. Help identify potential data quality issues, affecting timely, complete and accurate internal and external reporting requirements. and support resolution activities. Maintain version control and documentation for metric and report changes, and test, validate and educate before implementing in a live environment. Support data governance activities by ensuring documentation is current and accessible.
• Assist with reporting related to care gaps, preventive care measures, and chronic condition management. Support analytics for Annual Wellness Visits (AWVs), outreach methodologies, and population health initiatives. Validate attribution, care gap, and measure outputs under the direction VCO team, BI & senior analysts. Prepare summary outputs and data views to support point of service providers, population health, ambulatory teams, oversight committees and governance using a cascading inventory of integrated data results.
• Track and document updates to CMS, NCQA, HEDIS, and other quality or value-based care programs in concert with regulatory and contractual requirements. Maintain logs of measure, version changes, specification updates, and effective dates. Assist with measure mapping, code set updates, and verification activities. Support impact assessments of regulatory changes by preparing comparison summaries and documentation.
• Assist senior analysts and the Informatics Lead with gathering and documenting business requirements. Draft use cases, requirements summaries, and acceptance criteria for review. Participate in stakeholder meetings and document decisions, action items, and follow ups. Assist with preparation of training materials, job aids, and reporting walkthroughs. Provide frontline support for questions related to report access, definitions, and standard metrics. Assist operational and quality teams, oversight committees and governing body in understanding basic data outputs and trends. Prepare presentation materials, tables, and charts for leadership and stakeholder meetings. Escalate complex analytic questions or issues to senior analysts or the Informatics Lead.
• Performs other job-related duties as assigned.

Organizational Requirements:

Adventist Health is committed to the safety and wellbeing of our associates and patients. Therefore, we require that all associates receive all required vaccinations as a condition of employment and annually thereafter, where applicable. Medical and religious exemptions may apply.
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Adventist Health is a faith-based, nonprofit, integrated health system serving more than 100 communities on the West Coast and Hawaii with over 440 sites of care, including 27 acute care facilities. Founded on Adventist heritage and values, Adventist Health provides care in hospitals, clinics, home care, and hospice agencies in both rural and urban communities. Our compassionate and talented team of more than 38,000 includes employees, physicians, Medical Staff, and volunteers driven in pursuit of one mission: living God's love by inspiring health, wholeness and hope.