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Humana Physician Informaticist in Colorado Springs, Colorado

Description

The physician informaticist provide clinical insights and expertise for various analytic projects and coordinates with other analytics, IT and business areas across the organization to ensure work is completed under appropriate clinical governance.

Responsibilities

Come join the Digital Health & Analytics (DH&A) team within Humana to build a world class Data Science and Insights enterprise capability leveraging digital-first platforms, analytics, and agile development methodologies.

An opportunity to join the Digital Health & Analytics (DH&A) team within Humana to build a world-class analytics platform. Through the strategic interpretation of data, we provide our consumers-physicians, patients, and other members of the care team with meaningful insights about the choices they make and help them lead their best lives. We are passionate about combining and analyzing diverse types of data to extract new, actionable discoveries about our members and their health-related behaviors. We are looking for driven, innovative people who are interested in using their clinical and analytical skills to help our consumers achieve lifelong well-being and help Humana make lasting, positive changes in the healthcare industry. As an Informaticist at Humana you will contribute to meaningful projects, interact with other team members, be exposed to DH&A's business operations and work cross functionally with other departments.

Key responsibilities

  • Apply understanding of clinical and financial metrics to various data sets to help in the creation and implementation of clinical solutions based on advanced analytics

  • Advocate and build the process for clinical governance and quality within the organization

  • Apply knowledge in clinical terminology to map and group clinical codes to support various analytics projects

  • Provide clinical governance and validation on analytics solutions

  • Develop requirements and technical specifications for clinical rules and predictive models

  • Implement clinical rules with in-house developed rule language

  • Develop and review test cases for different analytics solutions

  • As SME in clinical informatics, coordinate with product management, IT and other business areas across the organization to support product development and adoption

  • Apply knowledge of clinical analytics processes to drive clinical efficiencies and effectiveness

  • Use informatics science to design or implement health information technology applications to enhance care management efficiency

  • Identify, collect, record or analyze data that are relevant to the optimal clinical care of patients

  • Design, develop, select, test, implement, and evaluate new or modified clinical informatics solutions

  • Exercises independent judgment and decision making on complex issues regarding job duties and related tasks, and works under minimal supervision, Uses independent judgment requiring analysis of variable factors and determining the best course of action.

  • Provide training to junior team members on clinical terminology management

Required Qualifications

  • MD or DO degree

  • 3+ years of direct clinical patient care experience post residency or fellowship, which preferably includes some experience in population health management

  • Current and ongoing Board Certification in approved ABMS Medical Specialty

  • Strong strategic thinking and planning capabilities

  • Excellent knowledge and experience with the National Coding Standards like LOINC, ICD 9/10, HCPCS or SNOMED CT

  • Experience in mapping and grouping clinical codes to clinical concepts at different granularity levels, data analysis experience using EMR or claims data

  • Deep knowledge or experience in health data exchange standard including FHIR, HL7, CCDA

  • Deep knowledge and experience with clinical quality measures like HEDIS, PQA, etc.

  • Proficiency in using data analytics technologies such as SQL, Power BI

  • Organized and detail-oriented

  • Knowledge or experience with advanced analytics, including machine learning and Natural Language Processing

  • Excellent verbal and written communication

  • Able to articulate and present findings and insights to senior leadership

  • Ability to teach others who are not expert in your clinical discipline

  • Experience creating a wide variety of documentation, paperwork, communications in an effort to advance a project or process

Preferred Qualifications

  • Experience in project management

  • Advanced degree such as an MBA, MHA, MPH

  • Experience working with Case managers or Care managers on complex case management, including familiarity with social determinants of health.

  • The curiosity to learn, the flexibility to adapt and the courage to innovate

Scheduled Weekly Hours

40

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