Quality Data Abstractor Senior

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 improvement and issue resolution.  Reviews Quality Dashboards for accuracy and takes action to resolve inconsistencies.
• Participates in data validations for both internal and external Quality Intelligence reporting, and other Quality Intelligence projects as assigned by Quality Intelligence leadership.
• Coordinates medical records retrieval with AAH, Aligned, and outside facilities to help improve data integrity and patient outcomes. 
• Maintains knowledge of most current regulatory standards, serves as a resource for and demonstrates compliance with applicable regulatory agencies.  Communicates findings and analysis of record reviews, audits, surveys, and other data to process owners and stakeholders.

License/Registration/Certification: None

Level of Education:  Bachelor’s Degree (or equivalent experience) in Health Care Administration, Population Health Management, Quality Intelligence, or related field

Experience Required:   5 years of Clinical, Quality Reporting, Data Abstraction, Data Analysis.

KNOWLEDGE, SKILLS AND ABILITIES REQUIRED

Experience working with Quality reports, EMRs, and clinical data.

Proficient with MS-Office software (Word, Excel, PowerPoint, Outlook, Teams).

Strong communication and networking skills.

Desire to learn with strong intellectual curiosity.

Ability to work independently for project completion with little to no supervision.

Demonstrates critical thinking, ability to problem solve, and is results oriented.

Competent application of performance improvement principles.

Demonstrated ability to work collaboratively with others as part of a team.

Statistical techniques to support analysis and interpretation of data.

Ability to create reports, graphs, and other visual presentation materials, and effectively maintain statistical data.

Analyze complex data, make inferences, and validate conclusions.

PHYSICAL REQUIREMENTS AND WORKING CONDITIONS

Ability to sit for extended periods of time.

Exposed to normal office environment.

Operates all equipment necessary to perform the duties of the job.

This job description indicates the general nature and level of work expected of the incumbent.  It is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the incumbent. Other related duties may be required.