BH Care Manager

About the role

MetroPlusHealth is a provider of healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens, and Staten Island. This position supports the data analysis, monitoring, evaluation, and reporting activities of the Partnership in Care (PIC) department.

Responsibilities

• Oversees data analysis, evaluation and reporting of HIV SNP’s Advanced Care Management (ACM) program activities, ensuring timeliness, completeness and accuracy.
• Maintains HIV viral load lab data collection to support viral load suppression quality improvement efforts.
• Performs analysis related to SNP audits and compliance activities to ensure adherence with regulatory requirements.
• Analyzes SNP recertification and membership data to monitor trends in SNP enrollments and disenrollments.
• Designs, plans, and implements of analytical business and technology solutions, i.e., Microsoft SQL Server, Tableau, and MS Excel to support PIC operations, coordinating and collaborating with the IT and Analytics departments as needed.
• Analyzes and monitors contractual compliance and business operations to evaluate inefficiencies (e.g., member enrollment, eligibility verification, retention).
• Analyzes monthly claims data alongside other data sources (gaps in care, CRG scores, etc.) to create member profiles and acuity scores.
• Identifies, prioritizes, and helps distribute members for outreach by PIC staff based on risk and acuity.
• Makes measurements and tracks key performance indicators and targets to effectively monitor PIC department activities including ACD line performance, staff productivity and quality outcomes.
• Performs extraction, import, and export of data from diverse data sources including various database applications.
• Packages data from a variety of reports into a monthly and quarterly PIC departmental dashboard.
• Provides training for internal and external staff regarding analyses, reports, or other relevant topics.
• Ensures accuracy and conducts validation of all reports and analyses.
• Performs statistical analyses to support monitoring and evaluation of PIC department.
• Develops and prepares reports, business presentations, and other materials.
• Aids in the identification, collection, input, and assembly of documents as required for external and internal audits.
• Aids in analysis and reporting for special projects as assigned.
• Attends approved in-service and external education and training as per department directives.

Requirements

• Bachelor’s degree in Computer Science, Information System, Business Administration, Health Administration, or related field is required.
• Minimum of five years of data analysis experience.
• Familiarity with analytics/BI reporting tools such as SQL, Tableau, and Power BI.
• Advanced working knowledge of Microsoft Office applications including Excel.
• Preferred experience in health care industry and knowledge of Managed Care plan operations.
• Knowledge of concerns of persons living with HIV/AIDS is preferred.

Professional Competencies

• Integrity and Trust
• Customer Focus
• Displays strong communication, interpersonal, and organizational skills across all levels coupled with effective problem solving, conceptual thinking, quantitative, and analytical skills.