Informatics Analytics Consultant (Hybrid - Troy, MI) - Health Alliance Plan

General Summary:

Provides assistance in completing comprehensive quantitative as well as qualitative analysis to support Medical Management strategic decision making.  Responsible for the development or coordinating the development and maintenance of the Care Management Platform, within Health and Network Management. The development process includes defining requirements, writing detailed specifications, assisting with programming, testing, debugging, implementing, & documenting application programs, and conveying new knowledge to colleagues.  Provide production support for business applications and resolve problems and issues quickly.  Provides accurate and timely regulatory report submission to entities including Centers for Medicare & Medicaid Services (CMS), MI Department of Insurance and Financial Services (DIFS), National Association of Insurance Commissioners (NAIC), and National Committee for Quality Assurance (NCQA).

Principal Duties and Responsibilities:

• Conduct analysis for Medical Management using all available data sources.  Prepare and deliver well-organized reports to reflect the findings, analytic methods and implications. Identify opportunities to drive improvement.  Ensure report accuracy and timeliness.
• Complete all assigned divisional regulatory and accreditation reporting with precision, accuracy, and by established deadlines, aligned with standards under CMS, DIFS, and NCQA.
• Initiate the analysis of, and ensure adequate evaluation of, Care Management system impacts.  Serve as the system experts and liaison with IT departments.
• Prepare recommendations for enhancements to the Care Management Platform, with prioritization based on the impact to compliance activities, cost savings, efficiency and satisfaction.
• Develop and execute a comprehensive test plans to ensure program accuracy.
• Make approved configuration updates to the Care Management Platform. Ensure Change Control processes are followed and that impacts to system performance (rules), interfaces and outputs (reports/letters) are well understood.  Make required technical, testing, policy and desk level procedure documentation updates.
• Prepare report and letter specifications.  Develop reports and letters using Crystal Reports or other report writing tool (or work with IT to develop).d
• Identify opportunities on an ongoing basis that would promote greater efficiencies in process and technology within Medical Management.
• Ensure continuous interaction with IT to maintain data integrity and to assure coordination between IT efforts and Medical Management's needs, in order to expedite responses and resolution of system problems/issues.
• Monitor project scheduling and completion. Perform ongoing quality review checks to ensure a quality implementation.
• Provide support to HNM trainers, as needed.
• Work with external vendors to evaluate, compare, and demo software packages.  Ensure software being considered fits within HAP’s technical arena.  Make recommendations to management based on evaluation. 
• Perform other related duties as assigned.