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Quality Measurement & Improvement Analyst-Senior

Independent Health -
Buffalo, NY

Apply Now

Job Details

Full-time
$85,000 - $95,000 a year
4 days ago

Benefits

Paid time off

Qualifications

Athena
Statistics
Medical performance measurement report preparation
Data Integration (Data management)
Data mining
Managed care
Team supervision
Data validation techniques
SAS
Managed care organization experience
R
Regulatory reporting
Business intelligence report generation
Software implementation
Amazon SageMaker
Gap analysis
Metrics Reporting
SAS language
Master's degree
Quality reports
Compliance reporting
SQL
Quality control data reporting
Technical solutions implementation
Quality performance measurement
Machine learning cloud services
HCPCS
Bachelor's degree
Clinical performance metrics
Statistical modeling

Full Job Description

FIND YOUR FUTURE

We'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 and Improvement Analyst–Senior 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. The Quality Measurement and Improvement Analyst–Senior 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 and Improvement Analyst–Senior 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 and Improvement Analyst–Senior will also provide critical support in the annual HEDIS and QARR data submissions and will help the Manager–Quality Measurement and Improvement Analytics respond to HEDIS auditor concerns as needed.

Qualifications

Bachelor’s degree in a quantitative/research discipline required. Master’s preferred. An additional four (4) years of experience will be considered in lieu of degree.
Five (5) years of analytics experience required, to include experience in SAS or SQL. Experience in a managed health care environment preferred.
Expert knowledge of Independent Health EDW, Health Rules, Beacon, and Medicaid FFS data and structures preferred.
Expert knowledge of Healthcare concepts and Healthcare data, for example, CPT, HCPCS, DRG, diagnosis codes, etc.
Strong understanding of HEDIS and QARR technical measure specifications and ability to create member level chase reports when requested.
Familiarity with NCQA certified HEDIS/QARR measure software (Cotiviti Quality Reporter preferred).
Working knowledge of LOINCs, SNOMEDs, CVX, other less common healthcare data codes and demonstrated ability to utilize these types of codes in reporting as needed.
Demonstrated ability to profile and integrate novel data sources into complex reporting.
Experience with cloud computing (AWS Athena, Redshift, SageMaker preferred).
In lieu of specific healthcare experience, a candidate can possess relevant experience dealing with large and structured datasets.
Fundamental knowledge of data mining concepts (courses or certification).
Expert knowledge of software used for statistical analysis, for example, SQL, SAS, R, Python, etc.
Expert 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.
Ability to lead and work with minimal supervision on multiple -complex projects at the same time.
Excellent problem-solving, interpersonal, analytical, and critical thinking skills. Ability to work with team members in a remote or office environment
Ability to train and lead junior analysts.
Ability to innovate and enhance existing solutions.
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. Work cross-functionally to ensure measure reporting is transparent to providers as needed.
Lead and work independently on multiple complex analyses at the same time in response to day-to-day requests.
Develop reports, charts, visualizations, or analyses to understand and explain drivers of quality measure trends.
Present output in user friendly manner.
Provide summary of results and recommendations when applicable.
Review and validate data and findings prior to releasing reports to QA analyst and customer to ensure accuracy.
Deliver work according to department SOP.
Proactively researches different topics or develops new ideas to support department goals or corporate strategic goals.
Assist in the design and implementation phases of new capabilities such as, vendor software, system applications, new data sources, etc.
The incumbent will be expected to keep up with latest research in these areas and apply these new techniques as appropriate.

Immigration or work visa sponsorship will not be provided for this position

Hiring Compensation Range: $85,000 - $95,000 annually

Compensation may vary based on factors including but not limited to skills, education, location and experience.

In addition to base compensation, associates may be eligible for a scorecard incentive, full range of benefits and generous paid time off. The base salary range is subject to change and may be modified in the future.

As an Equal Opportunity / Affirmative Action Employer, Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law. Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub.

Apply Now

Refine Your Search

senior quantitative jobs in buffalo, ny

Quality Measurement & Improvement Analyst-Senior

Senior Reimbursement Analyst

Business Analytics Sr Assoc

Senior Executive Strategic Operations Analyst

Senior Quantitative Risk Manager - BSA/AML

Managed Services - BI Engineer - Senior Associate

Senior Quantitative Risk Analyst - BSA/AML

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Sr. Software Engineer

Senior Manager, HR Partnership & Leadership - Human Resources

Life, Annuity & Group Benefits Operations Consultant - Sr. Manager

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