Resource will provide end-to-end delivery of reporting and analytics solutions in the Quality Incentive Program (QIP) domain ( Domain ). Resource will: (1) assess, recommend, and implement Performance Year 8 (PY8) QIP metrics assigned by the County; and (2) support and maintain those metrics in preparation for PY8 audits. The role requires consultant-level communication skills, the ability to coalesce related requests and offer solutions that satisfy multiple requirements, and Software Development Life Cycle discipline: gathering & documenting and confirming requirements gathering, designing solution, obtaining SME signoff, coding, testing/validation, UAT, & documentation.
Typical Tasks:

• Resource will assess and interpret assigned PY8 QIP performance metric specifications with the SMEs.
• Resource will recommend to the SMEs the specific assigned QIP performance metrics that are achievable during PY8.
• Resource will recommend pseudocode documentation to identify population inclusion/exclusion logic and validate that logic with SMEs for PY8
• Resource will prepare and implement the County approved pseudocode documentation and validate the assigned PY8 QIP performance metrics.
• Resource will peer test and unit test PY8 QIP performance metrics developed by the County.
• Resource will obtain the SME s approval on PY8 QIP performance metrics.
• Resource will provide data and other required Deliverables to support DHCS s PY8 QIP audit request.
• During the Term, Resource will collate source documents and prepare thedocumentation for each solution and save in the County s Software Development
• Lifecycle repository for future reference by the County.
• During the Term, Resource will prepare and provide County clinical and administrative leadership as well as health care providers with year-to-date metric performance reports, dashboards, and other analytics solutions to improve patient care, maximize metric performance, and achieve the highest possible, lawful QIP reimbursement from the State of California in PY8.

Required Skills & Abilities:

• Excellent SQL skills and familiarity with all clinical and financial coding tables
• Metric experience with pay-for-performance programs like QIP or HEDIS
• Development of playbooks for standardized coding

Desired Skills & Abilities:

• Experience with payor claims and eligibility data elements and structures
• Infrastructural skills in designing, transforming and using data structures including
• partitioning, data cleansing, to enable metric-related efficient queries. Balance between data structure and query load.
• Ability to interpret specs independently, revaluate pseudo code, and question decision points as appropriate

Certifications
Supplemental program development experience