Quality Analytics Project Lead

Responsible for reviewing and assisting in the coordination, planning, design and implementation of large scale projects, using cutting edge quantitative methodology to better understand the quality of care being delivered to our members. This position works with management providing analytical advice and support to define scope and resources of projects. Serves also as a liaison to external partners/organizations on important projects that require the performance of data analysis and reporting.

This role requires strong management and communication skills and good understanding of health care data. Acts as subject matter expert with SAS and/or SQL and be able to train internal staff on SAS and SQL techniques and best practices.

Duties and Responsibilities:

Responsibilities include, but are not limited to the following:

Continually analyzes clinical quality of care performance data to identify opportunities to improve services and outcomes for members and to monitor progress of improvement efforts

Provides technical support for collection of data through medical chart review and submission of collected data through synchronized data uploads

Perform all quality reporting for all Accountable Entities (AE) related work such as clinical quality of care analysis, HEDIS analysis and other related information

Provide analytical and technical support for the production of clinical quality care rates including:

Generate the HEDIS test and production files

Create test environments to ensure accurate HEDIS rates

Create and maintain libraries and quality standard documentation

Review and continuous improvement of report content and format

Analyzes and/or coordinates the production of clinical quality and other data to:

Identify opportunities for improvement in Neighborhoods clinical performance

Create reports supporting the implementation of intervention activities

Support continuous quality improvement of intervention activities

Attend all Quality Improvement committees and work groups

Supports the use of evidence-based findings to identify and select interventions designed to improve quality of care performance

Provides technical support and facilitation to multi-disciplinary teams formed to improve performance on specific quality of care measures or groups of measures

Aligns and coordinates with clinical quality improvement efforts in disease management, pharmacy, behavioral health and other areas within the company to achieve HEDIS improvement targets

Provide guidance and mentoring to other members of the team and the department

Trains Quality HEDIS Data Analysts on SAS techniques and best practices

Assist in the coordination, development and production of large scale and high-profile projects

Shared responsibility with the manager for representing the department and the organization on projects with external partners

Responsible for critically reviewing data analysis requests, assigning resources and assisting business owners in the interpretation of data and analysis results

Deliver regular feedback to the manager and director of the department on performance and project status

Coordinates information from multiple data sources, assures timely delivery of reports and analysis requests, performs quality assurance data review, helps senior management interpret data and contributes to continuous process and product improvement

Experience with data integrity strategies and process improvement

Performs other duties as assigned

Qualifications

Required:

Bachelor degree in a quantitative field, health related area or Information Technology Four (4)+ years of Managed Care/Health Care experience

Five (5)+ years of SAS and/or SQL development (SAS Preferred)
Three (3)+ years working with Medicaid and Medicare products

One (1)+…