Quality Intelligence Program Consultant

Advocate Health; South Carolina; Remote; USD 90,000 - 120,000; Full time

Benefits offered by this job

Health benefits

Retirement plan

Flexible spending accounts

Premium pay

Annual raises

Career development

Job summary

Advocate Health is seeking a remote Quality Intelligence professional to contribute to system-wide quality measures, data collection, and reporting. The role involves leading data analysis, developing dashboards, and communicating insights to drive improvements across departments.

The ideal candidate has a Bachelor’s in Health Care Administration or related field, 5+ years in quality analytics, and experience with HEDIS/NCQA payor data.

Qualifications

• Bachelor’s degree in Health Care Administration, Project Management, Quality, Engineering, or related field.
• Typically requires 5 years in Health Care Administration, Project Management, Quality Intelligence, or related field.
• HEDIS/NCQA Payor experience
• Knowledge of quality improvement methodologies, tools, and measures.
• Project Management methodology and tools.
• Statistical techniques to support analysis and interpretation of data.
• Ability to create reports, graphs, and other visual presentation materials, and effectively maintain statistical data.
• Excellent analytical and statistical skills with ability to analyze complex data, make inferences, and validate conclusions

Responsibilities

• Contributes to system-wide Quality/Health Outcomes measure development and definitions, goal setting, project improvement activities and work groups for AAMG and EPH.
• Maintains programming specifications and code lists for all quality measures in value-based agreements and internal reporting.
• Leads the development and adoption of processes and mechanisms for accurate quality data collection, analysis and reporting.
• Manages the interpretation, analysis, and communication of Quality data by engaging professionals in own department and leaders of other collaborating departments to drive improvements.
• Participates in the development of reports, files, and databases used for internal and external reporting.
• Ensures accuracy and optimization of quality data and is a resource for business intelligence, data analysis, and workflows supporting Quality initiatives and data integrity.
• Performs data validation to assure data accuracy and integrity (related to data feeds, measure mapping, etc.)
• Helps develop readily accessible and intuitive quality intelligence solutions (dashboards, dynamic reports, data visualizations, etc.)

Skills

Quality data

Data analysis

Statistics

MS Office

Education

Bachelor’s degree in Health Care Administration or related field

Tools

EHR tools

CMS/NCQA HEDIS knowledge

Job description

Department: 13577 Value Enablement Services - Value Based: Quality Status: Full time Benefits Eligible: Fulltime, Dayshift from Monday - Friday 9am - 5pm. This role will be fully remote. Fully Remote Role from these states: No relocation and no sponsorship or transfer of visa for this position now or in the future. Contributes to system-wide Quality/Health Outcomes measure development and definitions, goal setting, project improvement activities and work groups for AAMG and EPH. Maintains programming specifications and code lists for all quality measures in value-based agreements and internal reporting and partners with other data professionals to ensure timely communication of critical updates. Leads the development and adoption of processes and mechanisms for accurate quality data collection, analysis and reporting. Manages the interpretation, analysis, and communication of Quality data by engaging professionals in own department and leaders of other collaborating departments to drive improvements.

Participates in the development of reports, files, and databases used for internal and external reporting. Ensures accuracy and optimization of quality data and is a resource for business intelligence, data analysis, and workflows supporting Quality initiatives and data integrity. Performs data validation to assure data accuracy and integrity (related to data feeds, measure mapping, etc.) Helps develop readily accessible and intuitive quality intelligence solutions (dashboards, dynamic reports, data visualizations, etc.) Leads Quality Intelligence meetings with key stakeholders. Tracks and trends value-based payer quality performance data and analyzes improvement opportunities to inform the department strategy.

Manages and leads system improvement efforts, develops quality strategies related to internal and external quality measures and payer data feeds, and serves as the subject matter expert. Develops improved Electronic Health Record (EHR) tools to ensure complete data capture and to support the strategic priorities related to value-based agreements in collaboration with key functional departments and leadership.

Bachelor’s degree in Health Care Administration, Project Management, Quality, Engineering, or related field.

Typically requires 5 years in Health Care Administration, Project Management, Quality Intelligence, or related field.

HEDIS/NCQA Payor experience

Knowledge of quality improvement methodologies, tools, and measures.

Project Management methodology and tools.

Statistical techniques to support analysis and interpretation of data.

Ability to create reports, graphs, and other visual presentation materials, and effectively maintain statistical data.

Excellent analytical and statistical skills with ability to analyze complex data, make inferences, and validate conclusions

Experience with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Teams).

Demonstrates knowledge of value-based agreements, Accountable Care Organizations (ACOs), integrated health care operations and value based health care models. Knowledge of Information system tools, report programming, and measure development. Knowledge of Information system tools, report programming, and measure development. Knowledge of CMS, NCQA HEDIS, MA Stars and evidence-based guidelines.

Exposed to normal office environment. Operates all equipment necessary to perform the duties of the job.

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more - so you can live fully at and away from work, including:

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training
• Premium pay such as shift, on call, and more based on a teammate's job
• Opportunity for annual increases based on performance
• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Defined contribution retirement plans with employer match and other financial wellness programs

full-time, part-time, per diem, temporary, etc.; Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.