Director, Clinical Data Analytics & Performance

Overview

Under the direction of the Chief Medical Officer/Director of the Office of Clinical Affairs (OCA), or their designee, the Director of Clinical Data, Analytics, and Performance will oversee a broad portfolio of clinical data and analytics strategy, MassHealth plan and provider clinical performance management, and internal and external reporting. This will include policy and strategy development, oversight and accountability for performance managing MassHealth’s plans and providers to improve health care outcomes, and internally and externally communicating clinical performance data related to MassHealth’s plans and providers. 

Responsibilities

Clinical Data and Analytics

• Provide strategic leadership for and oversight of OCA’s clinical data strategy functions, including working across MassHealth teams to ensure data used to calculate clinical performance metrics used for value-based care programs are sufficient and accurate.
• Independently identify and resolve data quality/integrity issues impacting clinical measurement, including through demonstration of strong cross-functional management and problem-solving skills
• Lead clinical data strategy related to the evolution from hybrid quality measurement to electronic quality measurement
• Provide strategic leadership for and oversight of OCA’s clinical analytics functions, including related to analysis of quality, equity, and population health performance data to inform MassHealth clinical policy and programs.
• Lead analyses to answer clinical questions using relevant clinical data sources (e.g., Medicaid and Medicare encounter data, Medicaid claims data, supplemental clinical data); demonstrate knowledge of specific skills/tools or approaches to best implement various analyses

Clinical Performance and Reporting

• Development and oversight of the Office of Clinical Affairs clinical performance management strategy, leading cross-functional efforts to consolidate a comprehensive, enterprise-level view of MassHealth plan/provider clinical performance (as determined by quality measure performance, equity measure performance, population health metric performance, and/or other clinical metrics) to include:
  • routine monitoring and reporting of clinical performance measures;
  • identification of priority areas of clinical performance management for MassHealth, in collaboration with other OCA and MassHealth leaders;
  • oversight of planning for and implementation of high-impact engagements with plans/providers on their clinical performance;
  • Aligning and coordinating clinical performance management activities with other MassHealth teams
• Oversee the development and implementation of OCA’s clinical data reporting strategy, ensuring internal and external reports are aligned with regulatory requirements, internal performance priorities, deliver actionable insights, and are user-friendly and responsive for plan staff and leadership; ensure reporting strategy meets relevant regulatory or other requirements

Leadership

• Serve as a senior leader of the Office of Clinical Affairs, including a role on the OCA leadership team, leading strategic planning efforts, cross-Office team support and coordination, and focusing on integration across teams and workstreams to develop integrated and aligned strategy and team culture
• Serve as a lead interface for OCA for clinical data, analytics, performance & reporting with other teams throughout the agency including the Data and Analytics team, the Data Warehouse, the Accountable Care and Behavioral Health team, the Provider, Family, and Safety Net team, and the Office of Long-Term Supports and Services team to align data strategy with plan performance and reporting strategy, as well as identify and mitigate data issues impacting reports and analysis.
• Manage staff who are directly responsible for executing on projects to support data, analytics and performance & reporting goals.
• Provide support on intersecting clinical policy development and work;
• Other duties as assigned

Qualifications

• At least (5) years of full-time, or equivalent, experience working in health care clinical and/or quality measurement, healthcare data and analytics, and/or clinical performance management/improvement
• At least three (3) years of full-time or, equivalent part-time, experience serving in a supervisory or managerial capacity
• Advanced SAS/SQL (or similar software tool) programming skills
• Proficiency performing analyses using Medicaid or other payer claims and encounter data

Additional Information

PREFERRED QUALIFICATIONS:

• Senior manager with experience managing small-medium teams
• Previous work exp