Quality Analytics Project Lead

Paycom; Smithfield (RI); On-site; USD 90,000 - 120,000; Full time

Job summary

Neighborhood Health Plan of Rhode Island is seeking an experienced healthcare data analyst to review and coordinate large scale analytics projects. The role supports HEDIS reporting, clinical quality measures, and data submissions to external bodies.

You will generate test environments, maintain libraries, and create/maintain quality documentation. This position requires mentoring others, presenting to management, and training staff in SAS/SQL techniques.

Qualifications

• Bachelor's degree in a quantitative field, health-related area or IT.
• 4+ years Managed Care/Health Care experience.
• 5+ years SAS and/or SQL development (SAS preferred).
• 3+ years working with Medicaid and Medicare products.
• Experience with HEDIS data extraction and NCQA measures.
• Experience with SAS and/or SQL to extract/manipulate data using complex queries.

Responsibilities

• Review and coordinate large scale healthcare analytics projects.
• Provide analytical support for HEDIS, quality of care measures and reporting.
• Generate and review clinical quality of care rates and data submissions.
• Produce reports and dashboards for committees and leadership.
• Train staff on SAS and SQL techniques and best practices.
• Collaborate with cross-functional teams to improve quality outcomes.

Skills

SAS

SQL

Data analysis

HEDIS

NCQA

Medicaid/Medicare experience

Project leadership

Excel

Communication skills

Mentoring/training

Education

Bachelor's degree in quantitative field or health IT

Tools

SAS tools

SQL queries

Data warehousing tools

Job description

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 effortsProvides technical support for collection of data through medical chart review and submission of collected data through synchronized data uploadsPerform all quality reporting for all Accountable Entities (AE) related work such as clinical quality of care analysis, HEDIS analysis and other related informationProvide analytical and technical support for the production of clinical quality care rates including:Generate the HEDIS test and production filesCreate test environments to ensure accurate HEDIS ratesCreate and maintain libraries and quality standard documentationReview and continuous improvement of report content and formatAnalyzes and/or coordinates the production of clinical quality and other data to:Identify opportunities for improvement in Neighborhoods clinical performanceCreate reports supporting the implementation of intervention activitiesSupport continuous quality improvement of intervention activitiesAttend all Quality Improvement committees and work groupsSupports the use of evidence-based findings to identify and select interventions designed to improve quality of care performanceProvides technical support and facilitation to multi-disciplinary teams formed to improve performance on specific quality of care measures or groups of measuresAligns and coordinates with clinical quality improvement efforts in disease management, pharmacy, behavioral health and other areas within the company to achieve HEDIS improvement targetsProvide guidance and mentoring to other members of the team and the departmentTrains Quality HEDIS Data Analysts on SAS techniques and best practicesAssist in the coordination, development and production of large scale and high-profile projectsShared responsibility with the manager for representing the department and the organization on projects with external partnersResponsible for critically reviewing data analysis requests, assigning resources and assisting business owners in the interpretation of data and analysis resultsDeliver regular feedback to the manager and director of the department on performance and project statusCoordinates 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 improvementExperience with data integrity strategies and process improvementPerforms other duties as assignedQualificationsRequired:Bachelor degree in a quantitative field, health related area or Information TechnologyFour (4)+ years of Managed Care/Health Care experienceFive (5)+ years of SAS and/or SQL development (SAS Preferred)Three (3)+ years working with Medicaid and Medicare productsOne (1)+ year leading large scale analysis projectsExperience with methods to assess accuracy of HEDIS data extraction and HEDIS data manipulation processes, test HEDIS programs to ensure that they perform as intendedExperience with HEDIS specifications and program measures for NCQAExperience with HEDIS Performance reporting, Data Warehousing and NCQA accreditationExperience with SAS and/or SQL to extract and manipulate data to achieve desired results using select statements, sub-queries, functions, links of multiple tables, etc.Experience extracting and manipulating Claims, Provider, Member, Pharmacy, HEDIS and clinical dataAdvanced proficiency with standard office software primarily in ExcelUse statistical and analytical techniques for the analysis and interpretation of dataRepresent the team as a subject matter expert (SME) on various division and corporate initiativesSupport and inform business decisionsEvaluate programs or processes for cost efficiency reliability and qualityWrite technical reports detailing procedures, outcomes and observationsLead and provide direction to team members in the planning, execution and delivery of major projectsManage competing deadlines, variances in schedules and resourcesInitiate and plan projects in adequate detail (scope, resources, timelines, tasks, etc.)Strong interpersonal skills, with the ability to interact effectively with all levels of staff and members and clientsAbility to work independently with minimal supervision and in a team environmentStrong communication skills both written and verbalNeighborhood Health Plan of Rhode Island is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status