Manager, Health Informatics

Job Category:  Management/Executive
Department:  Quality Improvement
Location: 

Los Angeles, CA, US, 90017

Position Type:  Full Time
Requisition ID:  2689

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Manager, Health Information Management (HIM) is an important role on the Health Services team who will work closely with Health Service staff as a manager of cross-functional operations and improvement efforts including Operations teams and staff, in particular Shared Services, IT, EDSA and PNM. The Manager, HIM plays a key role in optimizing end-user experience of and data procurement from external stakeholders such as PPGs, MSOs and Plan Partners and streamlining operational processes for data flow and ultimately, outcome measure improvement. This manager is responsible for teams performing research, analysis, development and maintenance of performance reports and digital solution optimization programs in coordination with the CMIE, EDSA, IT and HIT.   This role will be an SME for VIIP and P4P/Incentives programs which are high profile projects for L.A. Care and it's CEO. This manager will create and maintain policies and procedures relevant to research and performance data programs involving rate calculations, reports and validation checkpoints which may involve other L.A. Care teams.  This role maintains an environment that promotes collaboration,  responsibility, accountability, and professional growth within the team environment for Informatics programs.

Duties

Works with and presents to Plan Partners and provider groups to optimize data quality and completeness in efforts to reduce variation. Directs standard operating procedures and processes for the Health Information Management to ensure HIPAA compliance and alignment with  policies regarding medical records management, including release of records, obtaining records, and accessing external EMRs. Identifies any changes that could improve current workflow and identifies method to address and resolve.

Initiates and participates in performance improvement initiatives and workgroups regarding cross-functional efforts such as Encounter Data Flow, Value Based Contracting, Management of Health Services IT requests etc. Supports internal cross-functional initiatives regarding HIM improvement efforts. Assists with the implementation of policies and procedures ensuring consistent application for all applicable processes.

SME to various cross-functional and external projects and programs including grant support such as TCPI, CNAP and WPC.

Develop analytic proposals for Data Science Platform for improving population health; Presents workflow changes to Director to discuss and develop an implementation plan if indicated. Develop and maintain Research Committee and Program.

Maintains staff by recruiting, selecting, orienting, and training employees; maintaining a safe, secure, and legal work environment; developing personal growth opportunities. Accomplishes staff results by communicating job expectations; planning, monitoring, and appraising job results; coaching, counseling, and disciplining employees; developing, coordinating, and enforcing systems, policies, procedures, and productivity standards.

Perform other duties as assigned.

Education

Master's Degree in Health Science, Information Systems. or Computer Science or Information Systems.

In lieu of Degree, relevant experience may be considered.

Experience

Required:
With Master's Degree:  At least 4 years of experience with HEDIS and Surveys (for example, CAHPS, CG-CAHPS, CAHPS- MAPD, QHP-EES, HOS, etc.) and Pay Fro Performance Programs.  

At least 3-5 years of progressive supervisor and/or management experience.

Equivalent Experience:
With Bachelor's Degree:  6-8 years of experience with HEDIS and Surveys (for example, CAHPS, CG-CAHPS, CAHPS- MAPD, QHP-EES, HOS, etc.) and Pay Fro Performance Programs.  

Required:
Advanced skills working with data types such as membership, provider, claims and encounters. 

Working knowledge of MS Access, Excel, and Word software.

Able to manage project timelines, requested deliverables and developing and maintaining prioritization thereof.

Knowledge of Medicare risk adjustment documentation requirements

Effective interpersonal and communication skills.

Ability to provide feedback effectively to clinicians and department staff


 

Professional Licenses

Professional Certifications

Required Training

Additional Information

Preferred:
5 years of experience  working with data types such as membership, provider, claims and encounters

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)


Nearest Major Market: Los Angeles

Job Segment: Medical, Claims, Medicare, Healthcare, Insurance