Payor Claims Epic Certified BI Reporting & Analytics Analyst Consultant

posted on February 12, 2020

Job Description

Location: San Jose, CA

Duration: 6+ Months

Principal Duties:

  • End-to-end delivery of reporting and analytics solutions in the Epic Cogito Clarity Ambulatory/Clinical applications space (Ambulatory, Practice Management, Tapestry Referrals, Grand Central, and Ancillary Services), plus the maintenance and refactoring of existing report inventory.
  • Areas of focus will include: Cost and Utilization reporting and analysis, Claims analytics, defined metrics and algorithms, Executive Analytics, Provider Performance, Health Maintenance, Patient Experience (e.g. Timely Access), pay-for-performance programs (e.g. PRIME and QIP), and additional duties as assigned.
  • Training and Experience: Sufficient education, training, and experience to demonstrate the possession and direct application of the following knowledge and abilities.
  • Minimum 3 years of Epic Clarity analytics development or Clarity Revenue

Knowledge of:

  • Minimum 3 years of Epic Clarity analytics development, at least one of year of which should be focused on claim analysis and reporting.
  • Advanced understanding and usage of Clarity data model
  • Working knowledge of medical claims reporting and analytics, as well as claims data aggregation
  • Experience with payor processes and operations in Medicaid/Medi-Cal, Medicare, and commercial lines of business.
  • Knowledge of CMS1500 and UB04 claim forms and data elements.
  • Strong SQL development using best practice industry standards
  • Exposure to utilization management concepts and pay-for-performance reporting as well as HEDIS / NCQA measure reporting a plus. Basic understanding of financial reporting and concepts in Epic (HB / PB) desirable but not required.
  • Create efficient queries optimized for best performance Epic-Crystal integration (ECI)
  • Tableau development experience


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