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Clinical Analyst – PT

OSS Health
Job Description
The basic function of the Clinical Analyst is to assist Physicians and staff in reporting and optimizing their Value Based Payment Quality Measures as required by various insurance companies.
 
Requirements and Responsibilities:
Education:
  • High school diploma or its equivalent required.
Qualifications
  • A minimum of 3 years of work experience in the medical field required.  Must understand medical terminology. 
  • Demonstrated understanding of Physician Clinical workflow, including how Clinical Specialist and Provider activity is documented in EHR. 
  • Previous experience in collecting data for PQRS, MUSE or comparable Physician centric Quality programs.
  • Must have the ability to develop and maintain working relationships with Providers and staff.
  • Experience with current EMR preferred.
  • Must possess proficient computer skills.
  • Must have the ability to work efficiently and prioritize tasks in a high volume practice.
  • Must have professional and effective communication skills and be able to deal with many different personalities.
  • Must be able to work both independently and as a member of a team.
 
 ESSENTIAL DUTIES AND RESPONSIBILITIES:
  • Develops and maintains working relationships with Providers and staff within OSS Health.
  • Participates in periodic educational events for providers and their staff.
  • Develops and maintains workflow-based educational material for Clinical Specialists and Providers, describing what needs to be done in order to meet the measure.
  • Provides an overview to new Providers and staff of the EHR workflow and how to use the system to ensure that the measures are properly captured.
  • Participates in the annual development of the location-specific Quality Program Work plan, including timeframes and responsibilities for key events.
  • Conducts and documents Value-Based Quality audits, ensuring that the data collected on an interim basis (in the dashboards) accurately reflects Provider workflows.
  • Summarizes and reports the audit results to requested parties. 
  • Randomly conducts audits of a sample of transactions by Provider or by Measure comparing the dashboard results to what is reflected in the EHR for Met conditions, Exclusions and Not Met conditions.
  • Reviews reported Quality results, identifying at the Provider level those with high, low and average performance rates.
  • Identifies Providers and staff that should be targeted for optimization support.  For these Providers and staff, develops an understanding of their workflows and use of the EHR as it relates to the reportable measures.
  • Diagnoses the root cause(s) behind lower than desired performance rates at a Provider level.
  • Develops action plans to fill the gaps and improve the performance rates.  Action plans may include Provider/Clinical Specialist education on the measures to include workflows and how to use the EHR to capture the data necessary to support the measures, IT/build changes necessary to deal with items such as exclusions, etc.
  • Manages and implements the changes necessary to close measure performance gaps.
  • Reviews reports PQRS and MUSE results, determining whether the implemented changes had the expected result.
  • Serves as the resident expert for Providers and staff program questions.
  • Provides periodic status reporting to Management.
  • Provides weekly/monthly reporting to Physicians and their staff.
  • Other duties as assigned.
How to Apply:
  • To view and apply for our job opportunities, please go to our website osshealth.com and select - Join our Team!
Contact Information