Clinical Business Intelligence Manager

Site: Mass General Brigham Health Plan Holding Company, Inc. At Mass General Brigham, we know it takes a surprising range of talented professionals to advance our mission—from doctors, nurses, business people and tech experts, to dedicated researchers and systems analysts. As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe a diverse set of backgrounds and lived experiences makes us stronger by challenging our assumptions with new perspectives that can drive revolutionary discoveries in medical innovations in research and patient care. Therefore, we invite and welcome applicants from traditionally underrepresented groups in healthcare — people of color, people with disabilities, LGBTQ community, and/or gender expansive, first and second-generation immigrants, veterans, and people from different socioeconomic backgrounds – to apply. This is a hybrid role that requires an onsite presence to the office in Somerville 1x/month. Job Summary Mass General Brigham Health Plan is an exciting place to be within the healthcare industry. As a member of Mass General Brigham, we are on the forefront of transformation with one of the world’s leading integrated healthcare systems. Together, we are providing our members with innovative solutions centered on their health needs to expand access to seamless and affordable care and coverage. Our work centers on creating an exceptional member experience – a commitment that starts with our employees. Working with some of the most accomplished professionals in healthcare today, our employees have opportunities to learn and contribute expertise within a consciously inclusive environment where diversity is celebrated. We are pleased to offer competitive salaries, and a benefits package with flexible work options, career growth opportunities, and much more. The Clinical Business Intelligence Manager reports to the Senior Clinical Operations Manager to support implementation of operational excellence and continuous improvement strategies within the Clinical department. The Clinical Business Intelligence Manager is responsible for the retrieval and analysis of data to review Clinical department operations and meet regulatory requirements. Qualifications Principal Duties and Responsibilities: Support performance management for clinical department Support identification, refinement, and continued monitoring of a focused set of key performance indicators to monitor operations across the clinical department including utilization management, quality, appeals and grievances, population health and pharmacy Establish and periodically refresh targets which support company goals, adhere to regulations, and align with industry standards Develop dashboards for Clinical and cross-functional teams and leadership audiences to periodically monitor performance measures and targets Monitor clinical department’s progress toward achieving performance incentives; establish/attend periodic review meetings with impacted stakeholders (e.g., sales, contracting, etc.) Escalate performance issues to process owners and/or leadership, as appropriate Develop, refine, and maintain clinical department reports Assist with acquisition and analysis of data to support required reporting for MassHealth Quality Improvement Goals, NCQA, and for program evaluations Conduct periodic inventory of Power BI reports; identify data/reports which should be created, updated, and/or retired in accordance with business needs Work to improve visualization of current reports using existing tools and new tools as they become available Gather and documents specifications required to facilitate reports for production Serve as an expert, “super-user” of available data sources (e.g., Data Warehouse, Provider Dashboard) and predictive modeling tools Facilitate data-driven decision-making through robust analyses and clear data visualization In collaboration with the Senior Clinical Operations Manager, perform trend analysis to identify risk and assess potential opportunities for improvement within department operations Evaluate and track the success of interventions and quality improvement initiatives, completing quantitative and qualitative analysis to support program objectives Develop scenario modeling using claims-based, clinical, and financial data and acquiring data in cooperation with service team leaders and support staff Perform ad hoc analysis to assess the impact on utilization and costs of various clinical management initiatives Interpret and summarize data using charts, graphics, and text to ensure key findings are appropriately communicated in presentations and other methods Serve as subject matter expert for clinical department Achieve and maintain awareness of activities of other clinical analysts Coordinate with clinical analysts to ensure consistency and best practices Assist business owners and analysts within population health, utilization and care management, and Quality with critical analytics needs Escalate risks, gaps, and barriers to achieving technical and/or data needs Promote cross-training of analysts within clinical department Support training of staff/management on key technical capabilities, as needed Assist leadership in scoping future analytic needs Foster collaborative relationships with customers and stakeholders Collaborate with other internal areas on special projects Develop effective relationships with leaders and staff in the clinical department and the Health Plan Collaborate with administrative, clinical leaders and other key stakeholders to support Clinical programs and performance improvement initiatives, understanding structured and unstructured data to determine insights and implement evidence-based interventions across stakeholder groups Present ideas, updates, findings, reports, recommendations, data, and analysis to various audiences to build consensus on program initiatives Use Mass General Brigham healthcare values to govern decisions, actions, and behaviors These values govern how we get our work done: Patients, Affordability, Accountability & Service Commitment, Decisiveness, Innovation & Thoughtful Risk; and how we treat each other: Diversity & Inclusion, Integrity & Respect, Learning, Continuous Improvement & Personal Growth, Teamwork & Collaboration Work with Senior Clinical Operations Manager on special projects and high-profile initiatives Qualifications: Bachelor’s Degree in a related field (e.g., statistics, mathematics, computer science, business administration, or a related discipline. etc.). Or the equivalent combination of training and experience, plus 5-7 years of related experience. Masters degree preferred. 3-5 years in business intelligence, data analytics, or related field (e.g., clinical informatics). Managed care and health care experience preferred. Expert in data analysis and visualization Expert in SQL server Experience with medical, behavioral health, and pharmacy claims and associated terminology preferred Experience with data extraction, data warehouse and data mining, data visualization, relational database systems, document management, and business planning Proficient with MS Office Suite, including Power BI, PowerPoint, Excel, and SharePoint Experience presenting to senior leaders. Skills/Abilities/Competencies: Demonstrate Mass General Brigham Health Plan’s core brand principles of always listening, challenging conventions, and providing value Strong analytical and problem-solving ability, high ownership of work product value, and commitment to driving reliable results Ability to translate and communicate complex topics in a variety of forums, tailoring communications to effectively fit and influence the targeted audience; strong executive presence, presentation, and communication skills; strong verbal, active listening, and written communication skills required. Ability to provide consultation to constituents to identify their needs Must be extremely detail oriented and draw well thought-out conclusions Ability to work independently, and as part of a team Collaborates well with others Accountable for delivering high quality work Strong aptitude for technology-based solutions Bring fresh ideas forward by listening to and working with employees and the people we serve Respects the talent and unique contribution of every individual, culture, and ethnic group and treats all people in a fair and equitable manner Exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback Excellent interpersonal skills, including the ability to influence others at all levels of an organization Strong EQ; exercises self-awareness; monitors impact on others; is receptive to and seeks out feedback; uses self-discipline to adjust to feedback Unquestionable integrity Supervisory Responsibilities: Manage multi-functional staff of 3-5 analysts. Inform, engage, inspire, motivate, and actively listen to employees. Make decisions that put the needs of the people we serve—our members, providers, brokers, and employers—front and center. Identify/create processes and align resources to accomplish key objectives; clearly convey and assign clear accountability for important objectives, deadlines, and expectations. Fiscal Responsibility: Provide insights and analytics to inform budget development, as appropriate Working Conditions: Normal office working conditions Remote with 8-12 visits per year on-site Diversity Statement As a not-for-profit organization, Mass General Brigham is committed to supporting patient care, research, teaching, and service to the community. We place great value on being a diverse, equitable and inclusive organization as we aim to reflect the diversity of the patients we serve. At Mass General Brigham, we believe in equal access to quality care, employment and advancement opportunities encompassing the full spectrum of human diversity: race, gender, sexual orientation, ability, religion, ethnicity, national origin and all the other forms of human presence and expression that make us better able to provide innovative and cutting-edge healthcare and research. EEO Statement Mass General Brigham is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Disclaimer The above statements are intended to describe the general nature and complexity of the work being performed by personnel assigned to this classification and do not represent an exhaustive list of all tasks, duties, and responsibilities required of personnel assigned to this position. Additional Job Details (if applicable) Remote Type Remote Work Location 399 Revolution Drive Scheduled Weekly Hours 40 Employee Type Regular Work Shift Day (United States of America) EEO Statement: Mass General Brigham Health Plan Holding Company, Inc. is an Equal Opportunity Employer. By embracing diverse skills, perspectives and ideas, we choose to lead. All qualified applicants will receive consideration for employment without regard to race, color, religious creed, national origin, sex, age, gender identity, disability, sexual orientation, military service, genetic information, and/or other status protected under law. We will ensure that all individuals with a disability are provided a reasonable accommodation to participate in the job application or interview process, to perform essential job functions, and to receive other benefits and privileges of employment. Mass General Brigham Competency Framework At Mass General Brigham, our competency framework defines what effective leadership “looks like” by specifying which behaviors are most critical for successful performance at each job level. The framework is comprised of ten competencies (half People-Focused, half Performance-Focused) and are defined by observable and measurable skills and behaviors that contribute to workplace effectiveness and career success. These competencies are used to evaluate performance, make hiring decisions, identify development needs, mobilize employees across our system, and establish a strong talent pipeline. Combat disease. Hold a hand. Help people. Impact the world. Mass General Brigham is a passionate, welcoming community where minds meet caring hearts. Come be a part of the world’s most powerful force in medicine, where every role is important in changing lives. Are you ready? Our history includes New England hospitals founded over 200 years ago, some of the first and most prestigious hospitals in the world. Built on the legacy of two leading academic medical centers, we’re more than a system—we’re leaders in the practice of medicine. Mass General Brigham is committed to serving the community. We are dedicated to enhancing patient care, teaching and research, and taking a leadership role as an integrated health care system. We recognize that increasing value and continuously improving quality are essential to maintaining excellence.