Care Management Business Data Analyst II

Job Category: Clinical

Department: Care Management

Location:

Los Angeles, CA, US, 90017

Position Type: Full Time

Requisition ID: 11254

Salary Range: $77,265.00 (Min.) - $100,445.00 (Mid.) - $123,625.00 (Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Care Management Business Data Analyst II supports quality and process improvement activities by producing Care Management (CM) measurements that are used for internal and external reporting, the tasks including data quality assurance, process programming, specification documentation and report developing.

The position applies technical skills to design, develop, and generate ad hoc or production reports that may evolve into complex data analysis/data integration projects that this position may be responsible for maintaining. The complex data analysis/integration projects are those which may require periodic maintenance on a weekly, monthly, quarterly, biannual, or annual basis. The position works with Information Systems analysts and Health Outcome & Analysis staff when ongoing reports can be accurately transferred for production.

The position interprets and documents both written and verbal specifications. The position takes basic instructions or specifications from appropriate CM staff responsible for delivering CM performance data in order to obtain complete details sufficient for writing data queries based for ad hoc and ongoing health care measures. The position must comprehend the relationships between the field elements in encounters and claims, membership, and provider databases. Must be able to apply and/or develop technical specifications for health care measures such as those used by Centers for Medicare and Medicaid Services (CMS), Department of Health Care Services (DHCS),National Committee for Quality Assurance (NCQA) and others as identified.

The position is a key resource to the Care Management department on application use. The position supports the functions related to quality improvement activities inclusive of ad hoc, monthly or quarterly reports that demonstrate health care outcomes in comparison to targets or national averages/percentiles published by recognized organizations such as NCQA and Center for Disease Control and Prevention (CDC/ CDCP).

For the projects directly assigned to the Data Analyst, this position will also perform project specific tasks, including data management, data analytics, project coordination, technical documentation maintenance report write-up as well.

Duties

Investigate and document organizational data flow and sources. Provide thorough documentation regarding current: 1) data sources 2) data flow 3) current process and procedures to code, group, Quality Control (QC), link and seed the data.

Develop automatic, robust and sharable SAS procedures and programs towards building a comprehensive clinical Care Management data repository (may be in collaboration with HO&A department).

Develop analytical programs, databases, routine procedures using SAS programming language. Develop automatic, robust and sharable SAS procedures and programs towards building a comprehensive clinical data repository.

Design, develop, and generate routine and ad hoc/production reports. Produce automatic, robust, timely and accurate results based on client specifications.

Maintains complex ongoing data projects and completes other related duties as assigned in addition to maintaining a comprehensive reporting work plan and tracks timing and completion. Produce accurate analysis as allowed by resources. Identifies and creates contingency plans when necessary to create valid results that meet the intent of the client's specifications .Work plan document is maintained and updated at all times. Produces periodic results as scheduled.

Communicate and work with essential and supporting departments regarding project details, plans and data sources (i.e. HO&A and IT departments). Reach consensus based on mutual understanding of business requirements/resource availability.

Perform other duties as assigned.

Duties Continued

Education Required

Bachelor's Degree in Health Science or Related Field

In lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree in Related Field

Experience

Required:

At least 3 years of health care experience.

Preferred:

At least 2 years of work experience in health plan.

Previous experience with report generation using health care data with focus on elements from encounter/claims, membership, and provider data.

Relevant project coordination/management experience is preferred.

Skills

Required:

Proficiency skills using MS Access, Excel, and Word software.

Basic SAS programming skills. Must demonstrate appropriate SAS skills in developing programs and procedures for analytics and quality assurance.

Demonstrated ability to use relational databases for the purpose of generating ad hoc reports.

The ability to work well in collaboratively with positions having professional backgrounds in the technical and/or clinical fields in order to achieve job duties and departmental objectives and responsibilities for the position.

Must demonstrate the ability to work independently and seek solutions proactively.

Able to apply critical thinking in evaluating priorities/solutions.

Must demonstrate the ability to analyze dataset in relational database environment.

Analytic skills include the ability to identify data aberrations and recognize data patterns that impact quality.

Must be able to present data in a format that is appropriate for analysis. This includes the ability to determine select the correct information for calculating basic rates, table configuration, and graphical presentations.

Must demonstrate an aptitude in learning and expanding abilities to use new applications with basic training.

Must be a self-starter and demonstrate the ability to multi-task and take charge and accountability of projects assigned.

Must be able to make recommendations to the report requestor that demonstrate strengths and limitations of the organization's ability to meet the request.

Preferred:

Medium SAS programming skills.

Past work with membership, provider, and claims encounter/claims.

Demonstrated ability to take responsibility for making sure requested projects meet the client's needs with respect to data accuracy, format, and timeliness.

Licenses/Certifications Required

Licenses/Certifications Preferred

Required Training

Physical Requirements

Light

Additional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

L.A. Care offers a wide range of benefits including

• Medical, Dental and Vision

• Wellness Program

• Paid Sick Leave