University of Maryland Medical System

Healthcare Data Analyst III - Remote/Hybrid

Job description

What You Will Do:

General Summary

Under limited supervision and with the latitude for initiative and independent judgement, this position conducts Case Mix analysis and reporting. This position works closely with the Clinical Documentation Improvement team which includes case managers, clinicians, medical records coders, and oversees the daily work activities of the financial analysts and intern(s).

Principal Responsibilities and Tasks

The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all job duties performed by personnel so classified.

1. Responsible for the integrity of both I/P and O/P abstract tapes. This task will include the following:

A. Supervising analysts analyzing and reporting the data as well as direct interaction with various hospital departments including clinical areas, Case Managers, Compliance, Medical Records Coders and Auditors, and Patient Financial Services.

B. Meeting all regulatory requirements including filing deadlines and integrity levels.

C. Maximize data for regulatory purposes by understanding what drives case mix changes and take responsibility of assuring all data is captured correctly. This includes, but is not limited to monthly reporting of Quality Indices to Medical Records.

D. Interaction with external auditing companies for financial data and medical records data. This includes sending and receiving data timely and accurately.

E. Accountability for the integrity of Case Mix data for reporting to management.

F. Reporting Case Mix information with all algorithms that have been established by the HSCRC

2. Supervises the reporting and monitoring of the Clinical Documentation Improvement team. This requires working independently with minimal supervision while meeting with various levels of management throughout the organization to implement effective case mix documentation which will ultimately lead to maximized Case Mix Index. This process will include the following:

A. Reporting case mix changes related to each of the clinical services within UMMS as part of the monthly reporting package.

B. Support the development, implementation and monitoring of improvements in clinical documentation as well as coding that will increase revenue for UMMS.

C. Analyzes actual case mix performance in comparison with established budgets. Interpret and reports results to all levels of management.

3. Supervise the monthly preparation and monitoring of various reports including monthly Financial Statement Revenue analytical packages, Case Mix Analytical Package, Clinical Documentation Improvement tracking as well as changes in CMI by clinical service at the detailed DRG level. Interpret and present information to management.

4. Supervises and directs financial analysts and interns who perform financial cost and rates analysis and reporting in accordance with departmental and UMMS personnel policies and procedures.

A. Completes individual performance evaluations under the supervision of management.

B. Assures timely and accurate completion of work by monitoring daily work activities.

C. Trains staff on new practices, and otherwise promotes staff professional development.

5. Supervises and prepares various case mix reports and special projects as requested by senior management.

6. Develops and implements procedures in performing tasks required by internal management or outside regulatory agencies.

7. Attends and participates in in-service training and various educational programs for professional growth and development. Keeps up-to-date with the developments/changes in the field and applicable regulations and procedures affecting hospital finance and regulatory practices.

8. Performs related duties as required.

What You Need to Be Successful:

1. A baccalaureate degree from an accredited college or university in Accounting, Finance, or other related field or equivalent is required. MBA, CPA or Master’s degree in Finance preferred.

2. A minimum of five years of progressively responsible professional financial/reimbursement analysis experience, or equivalent, is required.

3. Knowledge of Medicare and HSCRC regulations is required.

4. Demonstrated knowledge of Microsoft Access and Excel, word processing programs, graphic/specialty and other finance related software programs.

5. Highly effective verbal and written communication skills are necessary to work with various clinical department heads, financial management and senior management staff and to supervise professional and clerical staff.

6. Ability to assess and evaluate complex financial data via use of computer analysis.

7. Experience supervising, monitoring daily work activities, evaluating, training and motivating the performance of subordinate technical, professional and clerical support staff.

8. Proficient organization and problem-solving skills are required to develop/implement efficient work processes. Ability to work effectively in a stressful work environment. Ability to handle confidential issues with integrity and discretion.

We are an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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