POSITION SUMMARY:

Under the direction of the Senior Director of Clinical Quality Analytics Reporting, the Senior Clinical Data Abstractor oversees all clinical data abstraction completed as required by regulatory agencies. Along with providing direction, data validation and mentorship for the clinical data abstractors, the Senior Clinical Data Abstractor is accountable for timely and appropriate submission of data as it relates to regulatory agencies and/or payers.  The abstraction is related to (but not limited to) the Joint Commission, MassHealth, CMS, and Department of Public Health (DPH).  S/he is responsible for peer review, core measures, MassHealth, and other mandatory chart reviews including data collection, entry, aggregation, analysis, reporting and submission. The Senior Clinical Data Abstractor also supports quality initiatives as defined the Chief Quality Officer.  To meet this, the Senior Clinical Data Abstractor will be instrumental in understanding clinical workflows, measure specifications, and regulatory agencies.  S/he will be a standing resource for Analytics & Public Reporting.

Position: Senior Clinical Data Abstractor       

Department: Strategy and Analytics

Schedule: Full Time

ESSENTIAL RESPONSIBILITIES / DUTIES:

• Research, understand, disseminate, and aid in the implementation of all quality related regulatory requirements as defined by (but not limited to) the Joint Commission, MassHealth, CMS, DPH, and payers.
• Aid in ensuring that the following programs (but not limited to) are being successfully met: (1) Joint Commission - ORYX, (2) CMS – Core Measures, (3) MassHealth – Acute Hospital Quality Reporting Program, and (4) Payer P4P contracts.
• Support contracts related to third parties (e.g. medisolv) used to facilitate submission to external organizations such as CMS.
• Mentor junior Clinical Data Abstractors.
• Develop and implement systems, policies, and procedures for the identification, collection, and analysis of performance measurement data, data abstraction, and error adjudication.
• In coordination with the Chief Quality Officer (CQO) develop, implement, and maintain a standardized quality data management plan and program to ensure compliance with external regulatory and accreditation requirements.
• Collect and summarize performance data and identify opportunities for improvement through statistical analysis.
• Ensure consistency of quality data for the hospital’s internal data needs.
• Provide consulting services in the area of data quality management to individuals, special projects, and executive and clinical departments throughout the hospital.
• Coordinate the data flow for assigned performance measurement study sites and data collection.
• Receive, monitor, and evaluate performance measurement study data for compliance to protocol and procedural requirements; implement corrective action as required.
• Ensure that clinical interpretations are aligned with coding guidelines and educate staff regarding both indicator guidelines and coding guidelines.
• Ensure data accuracy through education and training and timely and appropriate communication of data definitions to those who collect the data.
• Retrieve data from numerous clinical databases within the hospital.
• Maintain expert knowledge of the relevant Joint Commission, MassHealth and CMS Core Performance Measurements and Ongoing Medical Record Review Indicators.
• Prepare and submit to CMS periodic status reports on specific Quality Improvement indicators selected by the Hospital.
• Work with Health Information Management (HIM) department to prepare and submit records for validation when requested.
• Utilize hospital’s behavioral standards and core values as the basis for decision-making and to facilitate meeting the enterprise mission of providing exceptional care without exception. 
• Follows established hospital infection control and safety procedures.

Performs other duties as assigned or as needed.

Must adhere to all of BMC’s RESPECT behavioral standards.

(The above statements in this job description are intended to depict the general nature and level of work assigned to the employee(s) in this job.  The above is not intended to represent an exhaustive list of accountable duties and responsibilities required).

JOB REQUIREMENTS

EDUCATION:

Bachelor’s degree required.  Clinical degree (MD, PA, RN, etc.) is preferred.

CERTIFICATES, LICENSES, REGISTRATIONS REQUIRED:

None

EXPERIENCE:

At least 5 years of professional experience in an abstraction role with documented increases in responsibility or in a clinical setting required. Trained and proficient in Core measure abstraction and/or experience in data quality preferred.

KNOWLEDGE AND SKILLS:

Required:

• Ability to create and manage large databases. 
• Ability to research, understand, and consolidate regulatory requirements and policies.
• Knowledge of statistics, process analysis, and outcome analysis. 
• Excellent verbal and written communication skills.
• Proficiency with Microsoft Office applications (i.e. MS Word, Excel, Access, PowerPoint, Outlook) and web browsers.
• Able to read and speak the English language.

Additional skills preferred:

Knowledge and experience in health information management and ICD-9 or ICD-10 coding practices preferred.

Equal Opportunity Employer/Disabled/Veterans