Quality Measurement & Improvement Analyst-Intermediate

Independent Health; United States; Hybrid; USD 70,000 - 80,000; Full time

Job summary

Independent Health is seeking an Intermediate Quality Measurement & Improvement Analyst to integrate data from multiple sources and develop complex analyses to explain quality trends. You will collaborate with business units to close care gaps and forecast trends, supporting annual HEDIS/QARR submissions and auditor responses.

The role requires experience in analytics within a health care setting, strong SQL/SAS skills, and ability to translate requirements into actionable reports.

Qualifications

• Bachelor’s degree required.
• Master’s degree preferred.
• An additional four years of experience may substitute for degree.
• Three 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 preferred.
• Familiar with cloud computing tools (AWS Athena, Redshift, SageMaker preferred).
• Knowledge of SAS, SQL, R, Python, or similar tools.

Responsibilities

• Develop standard reports using SAS, SQL, Quality Reporter or other tools to identify quality measure trends.
• Analyze drivers of quality measure trends and opportunities for gap closure.
• Provide quality measure rate modeling to support regulatory reporting requirements.
• Create custom quality measures in collaboration with managers/senior analysts.
• Collaborate cross-functionally to ensure transparent measure reporting to providers.
• Prepare outputs in a user-friendly format and present findings to stakeholders.
• Review data and findings for accuracy before release.

Skills

Analytics

SQL

SAS

Python

Healthcare concepts

Communication

Education

Bachelor's degree

Master's degree

Tools

Health Rules

Beacon

EDW

AWS Athena

Redshift

SageMaker

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.

Hiring Compensation Range

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. 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.

Equal Opportunity / Affiliation Statement

As an Equal Opportunity / Aff… Independent Health and its affiliates will not discriminate in its employment practices due to an applicant’s race, color, creed, religion, sex (including pregnancy, childbirth or related medical conditions), sexual orientation, gender identity or expression, transgender status, age, national origin, marital status, citizenship and immigration status, physical and mental disability, criminal record, genetic information, predisposition or carrier status, status with respect to receiving public assistance, domestic violence victim status, a disabled, special, recently separated, active duty wartime, campaign badge, Armed Forces service medal veteran, or any other characteristics protected under applicable law.

Company Culture

The Independent Health Family of Companies, headquartered in Buffalo, NY, serves nearly 400,000 members and provides innovative health care products and benefits designed to engage consumers in their health and well‑being. Established in 1980, our comprehensive portfolio includes Pharmacy Benefit Dimensions, Reliance Rx, Nova Healthcare Administrators, Care for You and the Independent Health Foundation. Our culture sets us apart. Our core values drive who we are and the work we do. As a member of our family, you’re part of something special, in your work and in the community. We understand and appreciate that everyone has unique experiences, perspectives and identities which is why we pledge to create a safe space where all people and ideas are welcomed. We are here to continue learning and to generate important dialog. We are committed to doing what matters most - reaching out, working together, and caring for our community. A healthy community benefits everyone who lives in it. You too can be part of making difference in the lives of others, together we achieve so much more. Please note, we do not accept unsolicited resumes. We do not accept resumes from headhunters, placement agencies, or other suppliers that have not signed a formal agreement with us.

We are committed to providing reasonable accommodations for qualified individuals with disabilities and disabled veterans. An applicant for employment in need of an accommodation to participate in the application and recruitment process should contact Human Resources at: [e-mail] or Human Resources, 511 Farber Lakes Drive, Williamsville, NY 14221.