Clinical Outcomes Analyst, Sr. collects clinical outcomes data and performs analysis in support of clinical process improvement initiatives. Responsible for gathering advanced data on performance metrics to facilitate the review of program effectiveness. Being a Clinical Outcomes Analyst, Sr. evaluates and summarizes patient data to ensure that care is provided in accordance with clinical guidelines and organizational standards. Identifies areas for improvement and communicates findings to leadership. Additionally, Clinical Outcomes Analyst, Sr. requires a bachelor's degree in nursing or healthcare related area. May require a Registered Nurse (RN) license. Typically reports to a manager. The Clinical Outcomes Analyst, Sr. work is generally independent and collaborative in nature. Contributes to moderately complex aspects of a project. To be a Clinical Outcomes Analyst, Sr. typically requires 4-7 years of related experience. (Copyright 2024 Salary.com)
Compiles and analyzes statistical data for Managed Care Contract decision making. Works with internal and external customers to interpret contract terms.
>FLSA: Exempt>EEO: 01 Officials and Managers 02 Professionals 03 Technicians 04 Sales Workers X 05 Administrative Support Workers 06 Craft Workers 07 Operatives 08 Laborers and Helpers 09 Service Workers
Develops, writes, and maintains profitability testing for all companies with an assigned insurance code.>Provides financial and utilization data to the Medical Director, Department Directors, and Case Management as requested.>Assists with provision and research of comparative regional and severity-adjusted data via PLM and other sources.>As needed, prepares reimbursement research to the CFO, the Controller, and department heads.>Verifies accuracy of Managed Care payments.>Reviews and works with the CFO on contract language on all renewed and new insurance contracts.
Minimum Education
X bachelor's degree in business with Accounting or Finance concentration X Required
Required Skills
Requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment and take appropriate action.
Minimum Work Experience
Three (3) years in a related position. Prefer experience in Cost Accounting or as Financial Analyst.
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