Quality Data Abstractor Senior

Department:

39709 AHP Administration - Quality Intelligence EPH II

Status:

Full time

Benefits Eligible:

Yes

Hours Per Week:

40

Schedule Details/Additional Information:

This is a remote role. Monday - Friday 8:00AM-5:00PM. Advocate may approve remote workers who reside in the following registered states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY.

Supports the implementation of strategic quality priorities for Advocate Aurora Medical Group (AAMG) and Enterprise Population Health (EPH) to drive top decile quality performance internally in system health outcomes goals and externally in health plan quality incentives, publicly reported metrics, Medicare Advantage (MA) Stars, Medicare Shared Savings Program (MSSP), and other value-based agreements to ensure quality and cost metrics are met for prioritized internal and external partners including those required or rewarded by government and payer relationships. Primarily responsible for ensuring accuracy and complete data capture for our internal and external Quality reporting, including our value-based agreements.  Provides timely, accurate, and reliable abstraction, and provides recurring / ad hoc reports and analysis of abstracted data to relevant stakeholders. The position is responsible for synthesizing and interpreting Clinical Quality data, evaluating trends and statistical significance, identifying opportunities and working with other departments to resolve issues and improve data integrity and patient outcomes.  Uses technology to help ensure achievement of AAH’s strategic imperative of top decile performance in quality, safety, service, and cost-effective patient care while demonstrating compliance with regulatory agencies.  This position is also responsible for other projects to help drive improved data integrity and patient outcomes such as coordinating with outside organizations the capture of medical records related to our internal and external quality measures, analysis of current data and resolving inconsistencies in the medical record, and other related projects.

MAJOR RESPONSIBILITIES

• Abstracts, reports, and submits clinical data from electronic medical records and other systems to support mandated and ad hoc data collection/reporting needs for both internal and external reporting programs and reconciles data on a regular basis.
• Oversight of specific quality measures and development, facilitation, and implementation of improvement plans.  Conducts chart reviews and identifies care gaps and takes action to close the gaps, including providing patient follow-up and connecting them to appropriate services.
• Applies AAH quality and high reliability improvement frameworks, methodologies, and tools, evidence-based practice, and data analysis to achieve optimal outcomes. 
• Uses statistical techniques to analyze and display clinical data using measurement tools and systems.
• Assists in the development and enhancement of tools for accurate data collection and quality improvement initiatives.
• Reviews and analyzes quality data for accuracy, patterns, and trends. 
• Able to navigate different source systems for data validation and collection purposes (EMR, claims, patient registry).  Maintains appropriate transmission, storage and archiving of data.  Partners with other Quality Intelligence professionals and internal IS dept on data request needs, specifications, and timelines.  Assists in medical record aggregation and organization to provide internal HIM dept for EMR scanning and data entry.
• Responsible for data reporting related to various initiatives including chronic disease and preventive initiatives.  Ensures that all data is managed in accordance with respective guidelines.  Ensures that all quality data is maintained and collected according to operational definitions established, issues are raised, data and results are accurately reported for internal and external reporting managed by the Quality Intelligence department.  Ensures that data from multiple systems is identified and utilized to reduce redundant processes.
• Analyzes and interprets administrative data, clinical data, and government quality data and measures, and appropriately applies critical thinking to identify opportunities for i