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Sr. Physician Hospital Organization Analyst

Cape Cod Healthcare

Hyannis, MA
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Cape Cod Healthcare
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Job Details

Cape Cod Healthcare

Department: HCI Phys Health Org - PHO
Schedule: Full-time 40 Hours per week
Shift: Day Shift
Hours: 9a-5p Monday-Friday, occ. w/e, occ. holiday
Job Details: Cape Cod Healthcare is the leading provider of healthcare services for residents and visitors of Cape Cod.  With more than 450 physicians, 4,700 employees, and 1,100 volunteers, Cape Cod Healthcare operates two-acute care hospitals, the Cape's leading provider of homecare and hospice services (VNA), a skilled nursing and rehabilitation facility (JML Care Center), an assisted living facility (Heritage at Falmouth), the Cape's only local laboratory service (CCHC Laboratory Services) and numerous health programs.  We are currently seeking a dedicated Sr. PHO Analyst to join our team at Cape Cod Healthcare.  


Cape Cod Healthcare offers competitive salaries, excellent benefits packages, tuition reimbursement, and generous paid time off.



Develops metrics, reports and related reporting infrastructure in support of Cape Cod Health Network's ("CCHN") care management programs and its objectives with respect to population health management and,  CCHN's and Cape Cod Healthcare's ("CCHC") contracting initiatives with various payers with respect to ongoing contract negotiations and existing contract performance.




1.       Assist CCHN and CCHC leadership with development of analyses of contract proposals, fee schedules, charge-master changes and contract performance for CCHN and CCHC.


2.       Utilizing knowledge of hospital and physician billing systems, Soarian reporting capabilities and other related sources, respond to ad hoc data requests and assist in the research and resolution of payer issues.


3.       Develop and/or maintain contract summary sheets, ad hoc utilization or contract value reports; maintain and update inventory of payer fee schedules and other documentation.


4.       Generate and analyze data from various sources including but not limited to: CCHC, CCHN, claims databases, health plan data, physician practice management systems, electronic health record, health information exchange network data as well as data and analytics produced by third party vendors


5.       Work with CCHN and CCHC data analysts on data validation and define clinical and other standards and specifications for measuring and reporting on population health as well as on a physician-specific basis with respect to quality, cost and care coordination performance.


6.       In coordination with the Medical Director and other PHO staff, analyze data to view population health trends and patterns; identify individual health risks and high-risk populations; find opportunities to improve care at the population and individual level.


7.       In coordination with the Medical Director and other PHO staff, develops credible metrics and internal/external benchmarks in order to measure PHO performance against "goal."


8.       Leverages physician report cards and other data/reporting in order to support CCHN's objectives with respect to development of value-driven, physician incentives.


9.       Identifies top physician performers and conducts detailed analysis to identify what distinguishes those who excel.


10.   Develop reports for use within the PHO in order to help the care team target the right preventative medicine priorities and identify gaps in care, medical errors and quality issues.


11.   Provide analytic support regarding the Cape Cod Healthcare Benefit Plan, using data from the CCHC's Third Party Administrator.


12.   Maintain collaborative team relationships with physicians, physician practice staff, PO Managers, CCHN PHO staff and others to effectively contribute to the achievement of goals.


Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Healthcare's commitment to CARES: "compassion, accountability, respect, excellence and service."



·         Minimum of Bachelor's degree or equivalent combination of education and experience to meet the needs of the position.

·         5 years of experience in healthcare informatics, managed care analytics or a related healthcare field.

·         Knowledge of and experience with reporting systems, relational databases and healthcare information systems required.

·         Ability to learn and master new information systems.

·         Microsoft Excel experience required; experience with Microsoft or other reporting platforms preferred.

·         Demonstrated competence in SQL preferred.

·         Knowledge of industry standard coding, such as ICD-9 and ICD-10, DRG, CPT, HCPCS, and revenue codes.

·         Ability to effectively prioritize multiple demands and quickly absorb new ideas and concepts.

·         Ability to present concepts and analytical results in a logical and concise manner.

·         Ability to work both independently and as part of a team.

·         Maintain information in a confidential manner in acceptance with policy.


HR Use Only:

Zip Code: 02601
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