EA Engineering Architect Clinical Data

AmeriHealth Caritas is hiring an EA Data Engineering Architect to manage clinical supplemental data used for HEDIS, STARS, CMS, and other quality measurement. The role develops ETL and business intelligence solutions, leads data acquisition and governance efforts, and collaborates with stakeholders to ensure data models and databases meet approved architecture standards.

Responsibilities:

• Design, develop, and test enhancements to ETL and BI solutions focusing on clinical supplemental data
• Act as key point of contact with internal and external stakeholders for supplemental data aggregators, health information exchanges, vendors, and provider-direct sources
• Partner with Information Services (IS) and key business stakeholders to align and manage an active Data Governance agenda where data is manipulated to yield actionable information for the purpose of evidence-based decision making
• Lead data acquisition efforts across the organization with the main focus of aligning Provider Network Management, Business Sourcing, and IS business functions to ensure contracts and data are accurately aligned
• Work with complex Data modeling and design patterns for BI/Analytics reporting requirements
• Lead ETL design and development initiatives including data analysis, source-target mapping, data profiling, change data capture, ETL coding, QA testing, and performance tuning
• Support technical development in designing, testing and implementing databases and data lake changes
• Collaborate with organization and department leadership in defining and modifying the supplemental data strategy through analysis of existing and potential sources to determine true impact, ROI, and areas of opportunity
• Participate in automation script code reviews and provide guidance on their compliance with automation best practices
• Demonstrate skills using code repositories
• Identify interdependencies, ambiguities or omissions and make suggestions to improve requirements and ensure usability/testability
• Learn rapidly and enthusiastically, focusing on understanding the application/product/area in detail
• Perform other duties as assigned by Management

Requirements:

• Bachelor's Degree in Computer Science or related field
• Minimum of 3 years of working with data mapping, scrubbing, quality assurance, and submission of clinical supplemental data
• Minimum of 3 years in interpreting, analyzing, and providing recommendations regarding data accuracy and data collection needs and processes
• Minimum of 3 years with SQL, Azure, Python, Tableau, Power BI or similar
• Minimum of 3 years with quality measure (HEDIS, CMS, STARS, NQF, and/or AHRQ) technical specifications
• Minimum of 3 years in health plan or major group/facility in similar data role
• Experience in an automation of reporting environment; agile environment, report automation engineering
• Experience working with clinical data specific to CCD, EMR/EHR/HIE data sources
• Experience with process improvement, workflow, benchmarking and / or evaluation of business processes
• Experience with provider relations
• Working knowledge of National Interoperability and Clinical Data Exchange standards including HL7, CCD/CCD-A, FHIR and traditional EDI
• Familiarity with HEDIS and other quality measure technical specifications
• Background in clinical quality management
• Excellent verbal and written communication skills; outstanding interpersonal skills; the ability to relate positively with individuals at all levels both internally and externall
• Proven ability to effectively communicate complex data and performance metrics to various audiences, including senior leadership
• Minimum of 3 years working with HEDIS platform software or similar preferred
• DQM a plus