Quality Measurement & Improvement Analyst-Intermediate

FIND YOUR FUTUREWe're excited about the potential people bring to our organization. You can grow your career here while enjoying first-class perks, benefits and a culture that fosters growth, innovation and collaboration.

Overview The Quality Measurement & Improvement Analyst-Intermediate will integrate data from multiple sources (claims, membership, provider, risk scores, EMR, ADT, etc.) to develop reports and complex analyses to understand and explain quality measure trends and the drivers for the trends with some assistance from the Manager of Quality Measurement & Improvement Analytics or other Senior Quality Measurement & Improvement Analysts. The Quality Measurement & Improvement Analyst-Intermediate will collaborate with key business units to identify areas of opportunity to close quality gaps in care and to forecast quality measure trends.

The Quality Measurement & Improvement Analyst-Intermediate will also work with the Quality Workgroup team on initiatives to improve specific quality measure rates as identified in various performance improvement programs from regulatory bodies. The Quality Measurement & Improvement Analyst-Intermediate will also provide critical support in the annual HEDIS and QARR data submissions and will help the Manager-Quality Measurement & Improvement Analytics respond to HEDIS auditor concerns as needed.

Qualifications Bachelor’s degree required. Master’s degree preferred. An additional four (4) years of experience will be considered in lieu of degree.

Three (3) years of analytics experience required. Experience in a managed health care environment preferred.

Knowledge of Independent Health EDW, Health Rules, Beacon, and Medicaid FFS data and structures preferred. In lieu of specific healthcare experience, a candidate can possess relevant experience dealing with large and structured datasets.

Intermediate level of understanding of healthcare concepts and data, for example, CPT, HCPCS, DRG, diagnosis codes, etc.

Strong familiarity with HEDIS and QARR technical measure specifications and ability to create member level chase reports when requested, with assistance.

Familiarity with NCQA certified HEDIS/QARR measure software preferred.

Ability to profile and integrate novel data sources into complex reporting.

Familiar with cloud computing (AWS Athena, Redshift, Sage Maker preferred).Knowledge of software used for statistical analysis, for example, SQL, SAS, R, Python, etc.

Knowledge of reporting tools, for example, Excel, SAS Visual Analytics, Qlik Sense.

Ability to translate customer requirements into reports/analyses and frame questions that create value for the business partners.

Ability to present and communicate complex output and statistical analysis in a meaningful way that meets the needs of and is easily understood by the business partners.

Excellent problem-solving, interpersonal, analytical, and critical thinking skills. Ability to work with team members in a remote or office environment.

Proven examples of displaying the IH values:
Passionate, Caring, Respectful, Trustworthy, Collaborative and Accountable.

Essential Accountabilities Develop standard reports using SAS, SQL, Quality Reporter or other reporting tool to identify quality measure trends. Work independently or with Quality Workgroup to understand drivers of quality measure trends.

Provide quality measure rate modeling to quantify opportunities for gap closure and to help identify measures that would be receptive to intervention, leading to higher benchmark achievement.

Develop custom quality measures as needed to support performance improvement program regulatory reporting requirements with assistance from manager or senior analysts. Work cross-functionally to ensure measure reporting is…