The Specialist will work closely with federal, state, and commercial clients as a subject matter expert (SME) and lead on projects or tasks related to clinical terminologies. The position can be located in RTI’s Research Triangle Park, NC headquarters. Other RTI office locations or telecommuting options will be considered.
Responsibilities include, but are not limited to:
- Analyze health IT and health data policies, regulations, requirements, and guidelines to support study design, implementation, or evaluation (e.g., ONC and CMS health IT regulations, quality payment program guidelines, quality measure specifications, program compliance/billing requirements, etc.)
- Analyze and map clinical content to the appropriate vocabulary, terminology and code set standard for representing and exchanging clinical or administrative data.
- Implement standards development organization (SDO) processes and best practices for mapping, new code requests, modifications to standards/vocabularies/code sets, conformance to FHIR implementation guides, etc.
- Ability to evaluate clients’ needs and design a technical approach that demonstrates an understanding of data structures and standardization, relevant health IT standards, policy priorities, and interoperability goals.
- Ability to evaluate the underlying logic/specifications, measures performance/benchmarks, value sets and standards of existing and proposed CQM/eCQMs and understand their alignment with intended quality improvement activities.
- Participate in relevant industry and SDO activities (e.g., workgroup meetings, connectathons) to support technical implementation and future changes in support of client needs.
- Provide support/response to stakeholders (e.g., federal/state clients, healthcare providers and health IT vendors) who raise questions about quality measure standards, logic/specifications, and documentation, billing, and coding requirements, etc.
- Prepare documentation for audiences that include federal agency program staff, healthcare providers and health IT vendors such as reports, white papers, memos, and presentations.
- Contribute to manuscripts for publication in peer-reviewed journals; present analyses at national quality, health IT and informatics-related meetings; author blog posts and impact briefs.
- Support business development activities as a SME including contributing to the development of proposals and requests for information, as required.
- Bachelor’s degree in related health field, e.g., public health, epidemiology, informatics or bioinformatics, and at least 10 years of relevant experience; OR a Master's degree in a related health field with at least six years of relevant experience.
- Experience with policies and initiatives related to data and exchange standards including the ONC Interoperability Standards Advisory, U.S. Core Data for Interoperability initiative, ONC Certification Rules, X12 Transactions, and other related federal and state regulations.
- Knowledge of HL7 standards and processes including Clinical Document Architecture (CDA) and Fast Healthcare Interoperability Resources (FHIR).
- Experience with healthcare/clinical terminologies and code sets that are used for clinical and administrative purposes including SNOMED CT, LOINC, ICD-10-CM, CPT-4, HCPCS, RxNorm, CVX, UCUM, and other code systems.
- Experience with tools to develop, maintain, and access value sets, such as the National Library of Medicine’s (NLM) Value Set Authority Center (VSAC).
- Knowledge of CMS’s Measure Authoring Tool (MAT), BONNIE testing tools, and related formats Quality Measure Format (HQMF XML) and Clinical Quality Language (CQL).
- Knowledge of CMS Quality Payment Program(s) (QPP), the Blueprint for CMS Measure Management System requirements, and National Quality Forum measure endorsement processes.
- Experience with Quality Data Model (QDM) and quality data reporting architecture (e.g., QRDA, QPP JSON, FHIR) and other HL7 standards as relevant.
- Excellent knowledge of MS Word, Outlook, PowerPoint, Excel.
- Strong organizational skills including ability to manage multiple priorities and work demands simultaneously, under deadlines.
- Strong written and oral communication skills including ability to bridge technical and clinical subject matter disciplines (e.g., ability to present technical topics to lay audiences), and to convey complex information clearly and concisely.
- Self-directed, continuous learner of new tools, techniques, and technologies for healthcare data and knowledge representation with experience monitoring emerging industry innovations to advance interoperability.
- To qualify, applicants must be legally authorized to work in the United States and should not require, now or in the future, sponsorship for employment visa status.
- Licensed or credentialed as a healthcare provider (e.g., RN, NP, PA) or health information specialist (e.g., RHIA, CCS).
- At least five years of experience in a U.S. based healthcare provider organization using an EHR system and/or with a health IT vendor that support providers delivering healthcare.
- Experience in research methods, consulting, contracting, or other service-related technical work.
- Knowledge of Application Programming Interfaces (APIs) and implementation of FHIR-based applications strongly preferred.