Quality Measurement & Improvement Analyst-Intermediate

Independent Health; South Dakota; Hybrid; USD 70,000 - 80,000; Full time

Benefits offered by this job

Scorecard incentive

Generous paid time off

Full range of benefits

Hybrid work arrangement

Job summary

Independent Health is seeking an Intermediate-level Quality Measurement & Improvement Analyst to integrate data from claims, membership, and providers to develop reports and analyses on quality measure trends. You’ll collaborate with business units to close quality gaps and support annual HEDIS and QARR submissions, under guidance from senior analysts.

You will help translate requirements into actionable insights, work with various data sources, and contribute to performance improvement

Qualifications

• Bachelor’s degree required; Master’s degree preferred; four years experience may substitute.
• Three years analytics experience; healthcare environment preferred.
• Knowledge of Independent Health EDW, Health Rules, Beacon; familiarity with large datasets beneficial.
• Understand CPT/HCPCS/DRG codes and healthcare data concepts.
• Proficient with SQL, SAS, R, Python for analyses.
• Experience with reporting tools: Excel, SAS Visual Analytics, Qlik Sense.
• Translate customer requirements into meaningful reports and analyses.
• Strong problem-solving, analytical and communication skills; able to work async or on-site.
• Demonstrated IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, Accountable.

Responsibilities

• Develop standard reports using SAS, SQL, or Quality Reporter to identify trends.
• Model quality measure rates to highlight gap closure opportunities.
• Create custom quality measures to support regulatory reporting with guidance.
• Handle multiple complex analyses concurrently with oversight.
• Produce visualizations and analyses to explain drivers of trends.
• Present output in user-friendly formats.
• Provide summaries and recommendations when applicable.
• Validate data and findings before release to QA and customers.
• Deliver work per department SOP and timelines.
• Explore new topics and data sources to support goals.
• Assist in design/implementation of new capabilities and tools.
• Stay current on research and apply new techniques.

Skills

Analytics

SQL

SAS

Python

Data visualization

HEDIS knowledge

Education

Bachelor's degree

Master's degree preferred

Tools

Health Rules

Beacon

EDW

SAS Visual Analytics

Qlik Sense

Excel

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 / AffClick here for additional EEO/AAP or Reasonable Accommodation information.