Information Systems Reviewer

The Public Health Institute (PHI) is an independent, nonprofit organization dedicated to promoting health, well-being and quality of life for people throughout California, across the nation and around the world. As one of the largest and most comprehensive public health organizations in the nation, we are at the forefront of research and innovations to improve the efficacy of public health statewide, nationally and internationally. PHI was distinguished as one of the top 50 “Best Non-profit Organizations to Work For” by the Non-Profit Times in a national search.

PHI is seeking an Information Systems Reviewer for the Behavioral Health Concepts, Inc. This position is located in Emeryville, CA.

Behavioral Health Concepts (BHC), a program of the Public Health Institute, is seeking qualified candidates for the position of Information Systems Reviewer (ISR) to work for the California External Quality Review Organization (CalEQRO) under a contract from the California Department of Health Care Services (DHCS). Centers for Medicare and Medicaid Services (CMS) requires external quality review of each of the 56 County Mental Health Plans (MHP) and each of the new Drug MediCal Organized Delivery Systems (DMC-ODS) in California on an annual basis. This involves reviewing multiple aspects of Substance Use Disorder and Mental Health treatment programs and operations to assess the plan beneficiaries’ access to services, quality of care, and timeliness of receiving services.

The ISR reports to the Chief Information Systems Reviewer and is responsible for conducting county mental health plan information systems review as part of larger, overall quality and performance review. The ISR must possess knowledge of information systems technology and operations including business processes and be able to assist the lead reviewer in all phases of a review including planning, conducting and report writing. The ISR will also assist the reporting manager in data analytical and quality control activities. The ISR will assist in the EQRO annual report production and will produce charts and graphs as needed. The ISR must be able to work in a team-oriented environment and be a quick problem-solver in various review situations involving MHP administration, staff, and/or consumers.

Duties & Responsibilities:

  • Conduct high quality, efficient IS site review (10%)
     
  • Evaluate Medi-Cal claims data summaries (5%)
     
  • Review performance measures data (5%)
     
  • Analyze Information Systems Capabilities Assessment (ISCA) Information (10%)
     
  • Use claims data, performance measures and ISCA information to populate IS data tables and develop review questions in consultation with the Quality Reviewer (15%)
     
  • Produce high quality and timely IS reports by triangulating claims, ISCA, onsite interview and focus group data (25%)
     
  • Assist the Chief IS Reviewer and DMC-ODS EQRO Director in developing, refining and standardizing IS report templates each year to meet the latest needs of Mental Health Plans, DMC-ODS Plans and DHCS (10%)
     
  • Research and provide appropriate and relevant technical assistance based on the state-of-the-art information for Mental Health Plans and DMC-ODS Plans on Information Systems, Practice Management, Electronic Health Records, Interoperability and Health Information Exchange, HIPAA and 42 CFR Privacy Rules, Medi-Cal Claims and Revenue Management, and Performance Measures as needed (20%)

Qualifications:

  • Bachelor’s degree in healthcare informatics, statistics, or related subjects, Master’s preferred Knowledge of health/behavioral health information systems and their various functionalities
     
  • Knowledge of county behavioral health claims and business processes
     
  • Knowledge of multi-server or WAN and data warehouse technology and services
     
  • 2-3 years of experience in behavioral health information systems auditing, programming, network administration, systems analysis and development; installation of software; user training; writing procedures and manuals
     
  • 2-3 years’ experience in data analysis using database/spreadsheet programs
     
  • Ability to review and analyze multiple sources of information/data
     
  • Ability to work in a diverse team and assume leadership as needed
     
  • Clear and concise report writing abilities
     
  • Ability to formulate probing, relevant questions that enhance the external quality review process
     
  • Ability to draw valid conclusions from available data
     
  • Meeting and group facilitation skills
     
  • Ability to interact with individuals from executive levels to supervisors, line staff, and beneficiaries receiving services in a professional and non-judgmental manner to deliver the right message
     
  • Ability to consistently meet report production deadlines
     
  • Ability to efficiently manage multiple priorities
     
  • Experience in facilitating/conducting meetings, groups preferred
     
  • Ability to do extensive travel within California - up to 25% of time
     
  • Must have available transportation and ability to commute to various locations other than the assigned office
     
  • Ability to drive long distance depending on the county being reviewed
     
  • Ability to travel up to 7,500 feet altitude depending on the county being reviewed
     
  • Ability to travel by plane depending on the county being reviewed
     
  • Car rental, hotel stays, staying within allowed per diem for meals while on review are standard practice for review trips
     
  • Some telecommuting may be allowed with supervisor’s prior approval
     
  • Full and part time positions available starting Fall 2017

Compensation:

This is an exempt position and the salary is commensurate with experience. PHI offers a generous benefits package including medical, dental, vision, short/long term disability insurance, life insurance, 403b (group retirement annuity) and partial subsidy of public transportation cost. For more information about PHI’s benefits, visit our benefits page at https://www.phi.org.

How to apply:

To apply for this position visit our Career Site at https://www.phi.jobs.

We are proud to be an EEO/AA Employer 
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Last Indexed: 
Sunday, March 18, 2018 - 18:00