Quality Measurement & Improvement Analyst-Intermediate

Independent Health Association; Buffalo (NY); Hybrid; USD 70,000 - 80,000; Full time

Job summary

Independent Health Association is seeking a Quality Measurement & Improvement Analyst-Intermediate to integrate data from claims, membership, and clinical sources to build reports and analyze trends. You will collaborate with business units to identify opportunities to close quality gaps and forecast trends, supporting annual HEDIS/QARR submissions.

You will work hybrid at our Williamsville location, applying SAS, SQL and other tools to deliver actionable insights and maintain regulatory

Qualifications

• Bachelor's degree required; Master’s preferred; additional four years of experience may substitute for degree.
• Three years of analytics experience in a managed health care environment preferred.
• Familiarity with HEDIS/QARR measure specs and ability to create member-level chase reports with assistance.
• Experience with large structured datasets and healthcare concepts such as CPT/DRG codes.
• Knowledge of cloud computing (AWS Athena/Redshift/SageMaker) and reporting tools (Excel, SAS Visual Analytics, Qlik Sense).

Responsibilities

• Develop standard reports using SAS, SQL, Quality Reporter or similar tools to identify quality measure trends.
• Model quality measure rates to quantify gap-closure opportunities and intervention impact.
• Create custom quality measures to support regulatory reporting with assistance from manager or senior analysts.
• Work cross-functionally to ensure measure reporting is transparent to providers as needed.
• Handle multiple complex analyses concurrently and respond to day-to-day requests with guidance.
• Present outputs in a user-friendly manner and provide summaries and recommendations.

Skills

SQL

SAS

R

Python

Excel

Data visualization

Communication

Problem-solving

HEDIS/QARR knowledge

Cloud computing

Education

Bachelor's degree

Master's degree preferred

Tools

SAS Visual Analytics

Qlik Sense

Health Rules

Beacon

EDW

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 & Improvement Analyst-Intermediate 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 with some assistance from the Manager of Quality Measurement & Improvement Analytics or other Senior Quality Measurement & Improvement Analysts. The Quality Measurement & Improvement Analyst-Intermediate 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 & Improvement Analyst-Intermediate 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 & Improvement Analyst-Intermediate will also provide critical support in the annual HEDIS and QARR data submissions and will help the Manager-Quality Measurement & Improvement Analytics respond to HEDIS auditor concerns as needed.

Qualifications

• Bachelor's degree required. Master's degree preferred. An additional four (4) years of experience will be considered in lieu of degree.
• Three (3) years of analytics experience required. Experience in a managed health care environment preferred.
• Knowledge of Independent Health EDW, Health Rules, Beacon, and Medicaid FFS data and structures preferred. In lieu of specific healthcare experience, a candidate can possess relevant experience dealing with large and structured datasets.
• Intermediate level of understanding of healthcare concepts and data, for example, CPT, HCPCS, DRG, diagnosis codes, etc.
• Strong familiarity with HEDIS and QARR technical measure specifications and ability to create member level chase reports when requested, with assistance.
• Familiarity with NCQA certified HEDIS/QARR measure software preferred.
• Ability to profile and integrate novel data sources into complex reporting.
• Familiar with cloud computing (AWS Athena, Redshift, SageMaker preferred).
• Knowledge of software used for statistical analysis, for example, SQL, SAS, R, Python, etc.
• 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.
• Excellent problem-solving, interpersonal, analytical, and critical thinking skills. Ability to work with team members in a remote or office environment.
• 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 with assistance from manager or senior analysts. Work cross-functionally to ensure measure reporting is transparent to providers as needed.
• Ability to work on multiple complex analyses at the same time in response to day-to-day requests with assistance from manager or senior analysts.

• 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 research different topics or develop 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.
• Remain current on the latest research in new capabilities and apply new techniques as appropriate.

This is a hybrid position with onsite attendance required at our Williamsville location.
Immigration or work visa sponsorship will not be provided for this position
Hiring Compensation Range: $70,000 - $80,000 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 / Affir... (full anti-discrimination statement) Click here for additional EEO/AAP or Reasonable Accommodation information.

Current Associates must apply internally via the Job Hub.