Clinical Business Analyst

Able Health is seeking a Senior Clinical Business Analyst with expertise in healthcare quality measures to help us implement value-based reimbursement programs and drive quality improvement throughout the US healthcare system. You will be in charge of our clinical rules engine and report directly to the head of product. You will also liaise across product and business functions, and interact regularly with customers. If you’re equally analytical and collaborative, this could be the role for you.

Role description

  • Author technical coding guidelines for the Able Health rules engine using a variety of healthcare quality measure specifications to including HEDIS, PQRS, and MSSP measures, and measures used in commercial P4P programs
  • Create custom value sets for use in Able Health measure calculations based on a range of measure specifications and customer needs
  • Rapidly learn requirements for new programs and deliver specifications for new program measures, with a focus on MIPS in 2017
  • Ensure ongoing accuracy of the rules engine, including managing and reviewing rules engine documentation and leading the ongoing rules engine update process
  • Provide expertise on programs and measures to inform product development at every level, from product strategy and road mapping to daily engineering questions related to measure coding
  • Work with customers to customize measure logic when needed to fit individual customer workflows
  • Work with customers to develop custom measures when needed, including variations on standard measures, and/or de novo measures based on customer guidelines
  • Work proactively with a multidisciplinary project team to ensure coded measures are accurate, and keep relevant stakeholders updated on project tasks and schedules

Required skills and experience

  • Deep knowledge of healthcare performance measure standards, methods for quality measurement, strategies for quality improvement, and clinical workflows and challenges
  • Extensive experience using measure source documentation from a variety of programs to author measure logic for rules engine
  • Working knowledge of common medical code sets such as CPT, HCPCS, ICD-10, NDC, and DRG codes
  • Some experience in data management including data acquisition, extraction, mining, integration, and error checking/validation
  • Track record of highly collaborative work across multi-disciplinary teams
  • Experience working on a software product team

Nice to have

  • Experience working with data from a variety of common sources, including various electronic health records systems and claims
  • Experience working in an agile software development environment
  • Experience submitting provider quality data to CMS, such as for PQRS or MSSP
  • Experience developing test cases for coded quality measures
  • Experience working with quality programs in a provider setting, either in-house or as a consultant
  • Experience participating in relevant industry workgroups and committees focused on quality measure development and/or quality improvement


  • Monthly stipend to cover medical, dental, and vision on your preferred plan
  • Competitive salary
  • Equity in an pre-Series-A, Y-Combinator-backed startup with customers
  • Opportunity to impact patient care and the daily lives of healthcare professionals
  • Working in a team with high EQ that values diversity

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