Job Description Type of Opportunity: Full Time FTE: 1.000000 Exempt: Yes Work Schedule: Days
Summary:Performs highly complex level of technical, project management support and analytical work under minimal supervision and with close collaboration with information system technology staff in support of the successful management of Clinical Operations software systems, programs, clinical content and tools. Develops and maintains clinical content and assists with configuration for software program functionality, coordinating input and review by appropriate parties such as Medical Directors, nurse managers, licensed behavioral health practitioners, care coordinators, long term care specialists, pharmacists, social workers and community health workers. Content includes physical, behavioral health and long term care. Assists with the development of training programs for the use of the system and ensures maximum use and benefits from the use of the software systems used by Clinical Operations staff as well as other internal and external customers of various levels. Manages on-going development and interpretation of Clinical Operation policies, procedures and guidelines for the use of the programs, reports and tools. Mentors and trains Clinical Operations Analysts. Performs other compliance related functions as assignedResponsibilities
Responsibilities:*Supervise project development by team members. Regularly evaluate status of projects and make needed adjustments.*Train other team members as needed on new processes and or software products.*Develops detailed expertise, knowledge and skills in the use of Clinical Operations software programs.*Develops clinical content such as risk assessment tools, care planning tools that drives the use and value of the care management software programs to support the care coordination programs processes and outcomes. Content includes physical, behavioral health and long term care, Obtain appropriate input and guidance from Medical Directors, nurse managers, licensed behavioral health practitioners, care coordinators, long term care specialists, pharmacists, social workers and community health workers.*Manages vendor relationships to enhance and maximize terms of the contract.*Develops and maintains clinical content and reporting packages to support both external required reporting as well as internal in support of the interdisciplinary care teams.*Works closely with Information Technology Services, Decision Support and Data Warehouse to develop clinical content for interfaces to the care management software.*Assists in management of care coordination staff work flow and skill development in use of the care management, data and reporting tools.*Trains and educates both external and internal users and promotes use of population health management software.*Uses data mining tools included in the care management systems to provide analysis of care management programs, cost, quality and utilization trends for the purpose of identifying the value of the program such as clinical outcomes productivity and staff efficiency for the development of interventions to address issues identified.*Maintains knowledge of national trends in clinical care coordination, health care cost, quality and utilization.*Performs other functions as required.
Other information:Bachelors Degree required. 6 years of additional experience can be substituted in lieu of degree. Five years experience in healthcare management, healthcare data management, nurse case management and/or behavioral health case management, and information technology experience preferred. Demonstrated ability through education and experience with reporting and analyzing health care cost, quality and utilization data. Able to teach others in the use of care management tools, data and reporting tools for various levels of users. Able to follow-up on multiple tasks with varied customer groups and to influence others without direct reporting relationship Education:Essential:* Bachelor Degree
- Jiva experience
- SQL experirence
Competencies and skills:Nonessential:* Analytics skills* SKILL-Accuracy and attention to detail are crucial* SKILL-Microsoft Office* Demonstration of high degree of independent problem solving and critical thinking skills.* SKILL-Demonstrate ability to work effectively in a team environment* SKILL-Demonstrated ability to communicate effectively in person and via telephone with members, employer groups, brokers, physicians, and physician office staff using strong dialogue and customer service competencies. * SKILL-Written communicationBenefits
Benefits Benefits are effective day-one (for .45 FTE and above) and include:
- Competitive salaries
- Full medical, dental and vision insurance
- Flexible spending accounts (FSAs)
- Free wellness programs
- Paid time off (PTO)
- Retirement plans, including matching employer contributions
- Continuing education and career development opportunities
- Life insurance and short/long term disability programs
About Us Presbyterian Healthcare Services is a locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, it is the state's largest private employer with approximately 11,000 employees.
Presbyterian's story is really the story of the remarkable people who have chosen to work here. Starting with Reverend Cooper who began our journey in 1908, the hard work of thousands of physicians, employees, board members, and other volunteers brought Presbyterian from a tiny tuberculosis sanatorium to a statewide healthcare system, serving more than 700,000 New Mexicans. We are part of New Mexico's history - and committed to its future. That is why we will continue to work just as hard and care just as deeply to serve New Mexico for years to come. About New Mexico New Mexico's unique blend of Spanish, Mexican and Native American influences contribute to a culturally rich lifestyle. Add in Albuquerque's International Balloon Fiesta, Los Alamos' nuclear scientists, Roswell's visitors from outer space, and Santa Fe's artists, and you get an eclectic mix of people, places and experiences that make this state great. Cities in New Mexico are continually ranked among the nation's best places to work and live by Forbes magazine, Kiplinger's Personal Finance, and other corporate and government relocation managers like Worldwide ERC. New Mexico offers endless recreational opportunities to explore, and enjoy an active lifestyle. Venture off the beaten path, challenge your body in the elements, or open yourself up to the expansive sky. From hiking, golfing and biking to skiing, snowboarding and boating, it's all available among our beautiful wonders of the west. AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.