Lead Analyst, Digital HEDIS & Quality Analytics

EmblemHealth; New York (NY); In loco; USD 78.000 - 149.000; Tempo pieno

Descrizione del lavoro

EmblemHealth is seeking a senior data analytics leader to drive the quality department's digital HEDIS strategy within the quality measurement analytics team. You will enhance data capabilities, automate reporting, and govern data sources to support HEDIS/QARR/Star metrics.

Collaborate with IT, vendors, and auditors to ensure digital readiness and prepare analytical dashboards for key stakeholders. You will lead complex analyses, develop automated dashboards, and provide guidance on quality

Competenze

• Bachelor's Degree in analytical/quantitative field including healthcare management, finance, business, mathematics, engineering, applied stats/economics, or related fields.
• Master's Degree preferred.
• 5 - 8+ years of relevant work experience.
• 5+ years of experience in managed care/healthcare analytics.
• Advanced knowledge of HEDIS and Medicare Stars.
• Proficient in Microsoft Office (Word, PowerPoint, Excel, Access).
• Experience with relational database applications (SAS, R, SQL, or others).
• Experience with programming languages/software (Python, VBA, R, SAS, C++, or others).
• Experience with data visualization tools (Power BI, Tableau).
• Strong communication skills (verbal, written, presentation).
• Self-starter with ability to develop projects end to end independently.

Mansioni

• Develop, implement, and manage reporting and reconciliation workflows and document processes.
• Lead medical trend studies related to quality initiatives.
• Identify data improvement opportunities from HEDIS/QARR/Star reports and data outputs.
• Collaborate with IT and others to plan digital readiness, including for FHIR.
• Engage with vendors and providers to identify new sources of clinical data ingestion.
• Perform data collection and mining, providing results to customers.
• Lead complex statistical analyses of quality metrics for Medicare and other populations.
• Develop and maintain automated quality dashboards and measure profiles.
• Provide analytical guidance for quality improvement and wellness initiatives; build self-service reports.
• Identify and analyze business problems related to member quality experience and STARS ratings.
• Present analytical findings to internal partners and lead further analysis discussions.
• Collaborate with quality management teams on quality improvement initiatives.

Descrizione del lavoro

Summary of Position

Lead the implementation of the quality department digital HEDIS strategy under the quality measurement analytics team. Lead efforts to continually improve data capabilities and quality of department analysis and reporting. Develop and implement automation of manual reporting and analysis of business implications and trends. Develop, automate, and manage the intake, use and data governance of clinical and supplemental data sources to support all HEDIS/QARR/Star metrics. Identify areas of opportunity and new data sources to support quality metrics. Work closely with quality department, IT, NCQA certified HEDIS vendor and auditors to ensure readiness for digital quality. Prepare and present analytical dashboards and data to key stakeholders to support strategic decision making.

Principal Accountabilities

• Develop, implement, and manage reporting and reconciliation workflows and document processes.
• Lead medical trend studies as they pertain to quality initiatives.
• Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues.
• Collaborate with IT and others to plan and execute digital readiness, including readiness for FHIR.
• Engage with vendors, providers, and others to identify new sources of clinical data ingestion (e.g. data aggregators, EHRs, HIEs, etc).
• Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department.
• Lead the development of complex and/or advanced statistical/modeling analyses of quality metrics for Medicare, State Sponsored Programs, and other populations.
• Develop and maintain automated quality dashboards and measure profiles utilizing data visualization tools.
• Provide analytical and technical guidance for design, development and maintenance of quality improvement and wellness initiatives. Build self-service reports to be used by the quality department.
• Identify and analyze business problems related to quality experience of member, particularly related to how members receive care and other factors influencing the STARS rating.
• Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis.
• Collaborate with internal quality management teams to assist on quality improvement initiatives.

Qualifications

• Bachelor's Degree in analytical/quantitative field including healthcare management, finance, business, mathematics, engineering, applied stats/economics, or any other related fields
• Master's Degree preferred
• 5 - 8+ years of relevant, professional work experience (Required)
• 5+ years of experience in managed care/healthcare analytics (Required)
• Advanced knowledge of HEDIS and Medicare Stars, including experience working with electronic clinical quality measures and related data sources (Required)
• Proficient in Microsoft Office (Word, PowerPoint, Excel, Access) (Required)
• Advanced experience with relational database applications (such as SAS, R, SQL, or others). (Required)
• Experience with improving and automating processes using programming languages/software (Python, VBA, R, SAS, C++, or others) (Required)
• Experience with and proficient in statistical software/programs (such as SAS, R, Stata, Minitab or others) (Preferred)
• Experience with and proficient in data visualization tools (such as Power BI, Tableau) (Required)
• Strong communication skills (verbal, written, presentation, interpersonal) (Required)
• Demonstrated self-starter with ability to develop projects end to end independently (Required)
  

Additional Information

• Hiring Range: $77,760-$149,040