Clinical Data Analyst Jobs in USA with Visa Sponsorship

INTRODUCTION

Clinical Data Analyst with HEDIS & Medicare 100% Remote 6+ months Contract

Must Have skills:

• HEDIS
• SQL
• Any professional coder certification
• Medicare Risk Adjustment

Responsibilities:

Responsible for conducting retrospective medical reviews to assess medical record documentation and monitoring submitted codes on clinical encounters for all lines of business. The Clinical Analyst is responsible for serving as an expert in data analysis, SQL, data intake/transformation and formulating recommendations and providing guidance to other data analysts. Analyzes member and measure level HEDIS and HEDIS-Like data and summarizes performance using available SQL tools and summary statistical procedures. Develops and analyzes business performance analyses and reports (e.g., for claims data, provider data, utilization data) and prepares data for HEDIS and HEDIS-like reporting purposes. Primary duties may include, but are not limited to:

• Conducts retrospective medical record and clinical data reviews to assess medical record documentation practices and accuracy/sufficiency of policies and procedures.
• Verifies accuracy/appropriateness of submitted diagnosis codes based on medical record documentation looking at both ways 1) appropriate detail in the medical record is not captured in what is reported, and 2) when reported information is not supported by details in the medical record.
• Identifies and recommends coding best practices to address unsupported additions/deletions, inconsistencies/discrepancies.
• Updates and develops policies and procedures and training/educating collateral to reflect best practices.
• Conducts on-going review, monitoring and communications to promote and ensure adherence to established protocols and best practices.
• Reviews documentation of well visits (annual well visits and other routine and preventative visits) including the use of appropriate modifiers for HEDIS scoring accuracy, Risk Adjustment, Clinical Research, Data Science and End-User Enablement.
• Conducts on-going review of medical records/practice notes to validate improvement, identify any new/additional opportunities to improve medical record-keeping, code more accurately, ensure on-going accuracy of submitted codes and accurate risk scoring and continues to verify coding accuracy and completeness to ensure compliance.
• Creates and publishes periodic reports, as well as any necessary ad hoc reports.
• This role is focused on quality data analyses and how it would be used to improve clinical usability of the data for a variety of end-use cases.

MINIMUM REQUIREMENTS:

Requires minimum of 3 years’ experience coding all types of medical records (including Medicare Risk Adjustment) in a physician practice setting or large group practice.

PREFERRED QUALIFICATIONS:

• Current Certified Professional Coder certification (CPC, CPC-H, CCS, or CCS-P) preferred but not required.
• Additional experience in procedural clinical coding preferred.
• Clinical experience or background (e.g., RN, LPN, foreign medical graduates) preferred.