McLean, Virginia, USA
20 days ago
Business Analyst, Clinical Measures
Overview As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home. It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you? Showing Up Somatus Strong We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make: Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say. Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more. Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests. Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions. Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners. Showing Up for You We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including: Subsidized, personal healthcare coverage (medical, dental vision) Flexible Paid Time Off (PTO) Professional Development, CEU, and Tuition Reimbursement Curated Wellness Benefits supporting teammates physical and mental well-being Community engagement opportunities And more! The Business Analyst, Clinical Measures is responsible for performing different tasks to ensure HEDIS data and reports are accurate, including investigation, auditing, and improvement opportunities. Responsibilities Compile and update the annual HEDIS measures matrix and the market updates to department heads With HEDIS department heads; make recommendations for chase logic; Trending and identification of measures that are “slipping” and need focus week over week Compile various internal and external reports; obtain approval and distribute as necessary Ensure that reports are analyzed and reported by responsible entities in a timely manner; Report specifications for productivity, measure gap closure tracking, etc. Create and maintain in partnership with department leaders audit tools, reports, standardized policies, procedures, and manuals Acquire a thorough knowledge of each program and/or department operations and procedures (as allowed) Collect, compile, trend, and report quality data in the following areas: HEDIS Measures Investigate, manage, and analyze variances New tech spec revisions – to include updating them in the training documentation (SME) Monitoring Insights and RC for weekly updates Trend productivity against gap closure and identify opportunities from reporting Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice. Qualifications Required Education and Experience: Bachelor’s degree Two (2) years of experience with HEDIS Strong clinical background Knowledge, Skills, and Abilities: Possess an intermediate level of knowledge of local, state, and federal laws and regulations on guidelines of provider and/or healthcare care management Ability to document and analyze complex business requirements and processes Strong analytical skills Ability to be both a strategic and tactical change agent in the healthcare space Self-starter who will take initiative and be proactive when there are multiple prioritiesStrategic solution-seeker who sees opportunities when others see barriers  Strong interpersonal skills and ability to communicate effectively Ability to handle ambiguity and desire to work in a fast-paced start-up environment Detail-oriented, accurate and complete work timely Ability to communicate in a courteous and professional manner with teammates, leadership, vendors, and others Proficient in MS Office Other Duties Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. Somatus, Inc. provides equal employment opportunity to all individuals regardless of their race, color, creed, religion, gender, age, sexual orientation, national origin, disability, veteran status, or any other characteristic protected by state, federal, or local law. Further, the company takes affirmative action to ensure that applicants are employed, and employees are treated during employment without regard to any of these characteristics. Discrimination of any type will not be tolerated.
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