Senior Clinical Informaticist

ESSENTIAL RESPONSIBILITIES

Combine knowledge of healthcare and experience in clinical settings to deliver value and insights through enterprise-grade data & analytic solutions.

Provide subject matter expertise related to the use of clinical ontologies, vocabularies and code sets in support of internally- and externally-sourced data. Includes support for bi-directional interoperability efforts across the enterprise.

In coordination with Enterprise Data Governance, assist with the development of business rules and associated code-based definitions related to clinical data domains. Includes but is not limited to sensitive data classification, disease states, clinical episodes, reimbursement episodes, pharmacy use, and care plans.

Work with teams across health plan, clinical, administrative, and IT business units to understand clinical data needs, evaluate opportunities to fulfill those needs through data and analytics, and participate in the build and delivery of analytic solutions.

Assist with design, build and deployment of robust analytic data solutions including but not limited to real-time/streaming analytics and alerting, data integration and interoperability, NLP, and AI/ML algorithms. Includes processes to convert prototypes into production solutions.

Provide clinical process and system expertise and training.

Other duties as assigned or requested.

EDUCATION

• Required: Bachelor's Degree in Nursing, Informatics, Health Information Management, Information Systems or related field, or relevant experience and/or education as determined by the company in lieu of bachelor's degree
• PREFERRED: Master's Degree in Nursing, Informatics, Health Information Management, Information Systems or related field

EXPERIENCE

• Required: 5 years of working in a Clinical Care setting - e.g., ambulatory, hospital, post-acute
• 3 years of hands-on experience with Electronic Health Record (EHR) system like EPIC, Cerner, Allscripts, or comparable

PREFERRED

• 3 years in Clinical Workflow, Clinical Systems, and the underlying data used to support clinical decision-making
• 3 years in Data Analysis, Analytics, Business Intelligence or Reporting
• 1+ years of working with healthcare claims data
• Experience supporting academic or scholarly research, including preparation of manuscripts and associated data documentation and reporting standards

LICENSES OR CERTIFICATIONS

• REQUIRED: None
• PREFERRED: Clinical licensure (e.g., nursing) OR Clinical coding certification

SKILLS

• Analytically strong and familiar with clinical informatics concepts, practices, and procedures
• Familiarity with healthcare vocabularies and code sets including ICD-10, CPT/HCPCS, SNOMED-CT, LOINC, and RxNorm
• Familiarity with healthcare interoperability concepts including HL7 v2.x, FHIR, IHE, X12
• Strong communication skills
• Intermediate to advanced SQL coding skills
• Familiarity with R/R Studio with basic R coding skills
• Proficiency in data cleaning, preparation, and transformation (e.g., restructuring) for analytic and research purposes

PHYSICAL, MENTAL DEMANDS AND WORKING CONDITIONS

• Position Type: Office-based
• Teaches / trains others regularly
• Occasionally Travel regularly from the office to various work sites or from site-to-site
• Never Works primarily out-of-the office selling products/services (sales employees)
• Never Physical work site required
• Rarely Lifting up to 10 pounds
• Constantly Lifting 10 to 25 pounds
• Rarely Lifting 25 to 50 pounds