Informatics Nurse (closed)
Informatics Nurse is responsible for the analysis of clinical data and application of clinical systems to further the goals of the organization while adhering to regulatory and departmental data integrity standards and requirements to support contractual obligations with the NYSDOH, LDSS,CMS and NJ DMAHS. Works in concert with the Medical Management/Appeals and Grievances Management and with clinical departments, information services, operational units and external organizations to create, submit and maintain information and data required to support the Medical Management Department and Appeals and Grievances Department all Medical Management Programs and across all product lines.
Essential Duties and Responsibilities:
- Provides prospective, concurrent and retrospective analysis utilizing the most current data sets available to identify and support improvement activities designed to enhance clinical programs within Medical Management and Appeals and Grievances.
- Supports strategies with clinical data. Supports clinical strategies including measuring the effectiveness of care management programs to maximize member outcomes. Supports strategies with medical leadership to identify opportunities to improve data collection and monitoring of medical management programs.
- Plans and implements Informatics projects. Act as liaison between Medical Management and Information systems. Builds and maintains positive relationships with internal and external business partners and customers.
- Creates and maintains reports that identify opportunities for improvement and supports strategies to automate processes and allocate resources to performing data analyses that identify opportunities for improved outcomes of care. Develops queries to identify and analyze data across multiple data sources and creates report cards for prospective and current Medical Management initiatives.
- Utilizes data to develop new knowledge
Bachelor’s degree is required.
Other Requirements (License, Certificate, Other):
RN license in NY.
5 – 8 years.
Basic Microsoft Word and PowerPoint skills are required. Intermediate Excel/VNA Programming, SQL, and SAS Programming skills are required.
While performing the duties of this job the employee will be occasionally reaching, bending, walking, and overhead lifting. The employee will also be frequently sitting and keying.
While performing the duties of this job, the employee constantly works in an indoor environment.
- 3+ years of experience in managed care organization , preferably in medical management
- Knowledge of DOH and CMS regulations
- Communicates complex information and interacts with all levels of management.
- Communicate effectively verbally and in writing
- Communicate professionally and courteously with all internal and external partners and with a diverse population.
- Handle the essential job functions independently as well as being able to work effectively in a team environment.
- To organize and prioritize work demands effectively in order to complete all responsibilities. Must be able to multi-task and efficiently work in a demanding and fast paced environment.
- Apply Total Quality Management and Continuous Quality Improvement tools and methods.
- Use and operate a laptop and other electronic devices.
For additional opportunities, please visit our website: http://www.pride-healthcare.com
Please fax or email resumes to:
Manager of Healthcare Recruitment
420 Lexington Avenue, Suite 2220
New York, NY 10170
212.235.5365 - direct
212.235.5350 - main
212.599.3427 - fax