Online Technical Services · 6 hours ago

Pay for Performance analyst

United States

Contract

Remote

Mid Level

$80/hr - $90/hr

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Responsibilities

Assess, recommend, and implement Performance Year 8 (PY8) QIP metrics assigned by the County

Support and maintain those metrics in preparation for PY8 audits

Qualification

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SQLHEDISQIPPay-for-performance metricsClinical codingFinancial codingPayor claims dataData structuresData cleansingMetric interpretationIndependent spec interpretationPseudo code evaluation

Required

Excellent SQL skills and familiarity with all clinical and financial coding tables

Metric experience with pay-for-performance programs like QIP or HEDIS

Development of 'playbooks' for standardized coding

Experience with payor claims and eligibility data elements and structures

Infrastructural skills in designing, transforming and using data structures including partitioning, data cleansing, to enable metric-related efficient queries

Ability to interpret specs independently, revaluate pseudo code, and question decision points as appropriate