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Company Name: Winchester Healthcare Management

Job Title: HIGHLAND MANAGEMENT INFORMATICS SPECIALIST

Location: Woburn, MA

Profession: Business Analysis (Software Implementation)

Job Description:

HIGHLAND MANAGEMENT INFORMATICS SPECIALIST
Department:    Winchester Highland LLC
Req Number    09-386
Posted    Sep-28-2009
Schedule:    Full-time
Shift:    day shift
Hours:    Monday - Friday 8:30am - 5:00pm

The Highland Management Informatics Specialist will provide insight regarding the organization's clinical and quality performance through the use of software and systems to support Clinical Integration, Quality and HEDIS goals. Analysis entails drawing inferential and statistical knowledge from large internally-maintained datasets including pharmacy, claims and claims data, and/or other segmentation grouper or predictive modeling tools for related analysis and quality profiling. The ideal candidate will have 3-5 years specific experience in data analysis for a managed care organization with analytical experience in the evaluation of healthcare claims data including utilization patterns, provider profiling, healthcare quality metrics, $PMPM trend analysis, loss ratio studies, etc. Experience with databases, SQL Server and MS Office applications are preferred along with a strong fundamental knowledge of managed care contracting, capitation, use of CPT codes, claims and eligibility data structure, and all related concepts. Development experience in management reporting (both designing and programming key report views) as well as excellent communication skills and a desire to accept expanding levels of responsibility.

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