Clinical Informatics Subject Matter Expert - REMOTE

Job Description:

***Crop to Crop resumes are accepted

The Clinical Informaticist acts as a Subject Matter Expert (SME) in clinical data and quality measurement, providing critical support to clinical evaluators, product teams, and data validation initiatives.

The ideal candidate will have:

·       A strong understanding of clinical documentation, EHR systems, and data interoperability

·       Experience working with clinical coding systems such as SNOMED CT, LOINC, ICD, CPT, and RxNorm

·       Experience with quality measurement programs and tools (e.g., HEDIS, eCQMs, dQM)

·       Ability to bridge clinical and technical domains

·       Familiarity with NC HealthConnex or other HIE platforms

·       Experience with CMS Data Aggregator Validation (DAV) and Primary Source Validation (PSV) programs

·       Understanding of HL7, FHIR, and other healthcare data standards

·       Knowledge of SAS tools and analytics platforms is a plus

·       Strong clinical and analytical skills

·       Effective communication and collaboration across clinical and technical teams

·       A detail-oriented and highly organized approach

·       Ability to work independently in a fast-paced environment

·       Commitment to data quality and health system improvement

·       Ability to participate in product testing and technical validation

Duties include but are not limited to:

·       Serve as a clinical SME for NC HealthConnex solution teams, providing insights on clinical concepts and data use cases.

·       NCQA Data Aggregator Validation Program

·       Support clinical evaluators with interpretation and validation of clinical resources and content.

·       Provide clinical expertise and guidance in support of the NCQA Data Aggregator Validation program activities, including primary source validation (PSV) processes

·       Assist with preparation, submission, and maintenance of documentation required for DAV certification.

·       Digital Quality Measurement (dQM)

·       Support the implementation and operationalization of the dQM engine.

·       Assist with aligning clinical data sources and formats to quality measurement specifications.

·       Data Quality Improvement

·       Collaborate with technical and clinical teams to identify and resolve data quality issues.

·       Provide recommendations for improving the accuracy, completeness, and usability of clinical data within NC HealthConnex systems.

·       Product Development Support

·       Contribute to new product development and enhancements by offering clinical perspectives that inform technical design.

·       Participate in product testing and validation for clinical functionality.

Education:

·       Clinical degree or licensure (e.g., RN, MD, NP, PharmD, or other licensed healthcare professional).

·       3+ years of experience in clinical informatics, healthcare IT, or health information exchange environments.

 Required Skills:

Clinical Informatics Expertise - Knowledge of clinical workflows, EHRs, documentation, and healthcare data management.

Healthcare Data Standards - Expertise in HL7, FHIR, SNOMED CT, LOINC, ICD, CPT, RxNorm, and interoperability standards.

Quality Measurement & Validation - Experience with HEDIS, eCQMs, dQM, NCQA DAV, and Primary Source Validation programs.

Data Quality & Analytics - Ability to analyze, validate, and improve clinical data quality, accuracy, and completeness.

Collaboration & Communication - Ability to translate clinical needs into technical requirements and work across diverse teams.