Job Description Responsible for the management and maintenance of locally stored databases and other files necessary for coordination and tracking of patient outreach efforts for claims data sharing, and proper physician attribution. Retrieves and loads claims files to synthesize data and cost and utilization information as necessary to support Kootenai Care Network (KCN) functions and operations. Validates payor data files by importing into population health analytics tool and matching to source data. Reviews physician attribution and creates exception reports for any variances noted. Produces physician information packets including dashboards and other clinical and financial reporting for provider meetings using existing data systems and files. Develops and distributes attribution, financial, utilization, and high cost/high risk patient reporting to inform KCN participants and shape and monitor KCN strategy. Interfaces with other KCN operations and decision-making personnel to provide data and reports as needed. Familiar with a variety of the field's concepts, practices, and procedures. Relies on experience and judgment to plan and accomplish goals. A certain degree of creativity and latitude is expected. Performs other related duties as assigned.
Minimum Qualifications: Bachelor's degree required with preferred emphasis on IT, finance or business. 3 years' experience required in data analysis; healthcare or health plan experience preferred Intermediate to Advanced Excel, Access, SQL and other database programs Highly organized and able to interface with various levels within and outside the organization
Essential Job Functions (Physical Requirements): Regular and predictable attendance is an essential job function. Majority of shift spent sitting. No or very limited physical effort required. No or very limited exposure to physical risk. Communicate with patients, physicians, families and co-workers in person and on telephone. Work with equipment and manipulate equipment settings, computer keyboard, etc.
Work Environment: · KH operates 24 hours per day each day of the year; operational needs of departments may require that you be available to work all shifts, weekends and holidays to meet the needs of the patients. · Work is normally performed in a typical interior work environment.
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