1. Research and Analysis: Analyze data for the purpose of identifying opportunities to improve the quality and cost of health care. Extract data from electronic medical records, claims, HMSA Data Warehouse and other available sources. Apply data analysis methods to identify trends and root causes and make recommendations based on results. Apply understanding of standard quality measures (e.g., HEDIS, CAHPS, HOS) to identify additional strategic improvement levers (e.g., supplemental data, benefits alignment) that may impact quality outcomes. Complete procedural documentation that supports each analysis performed. 2. Application and Data Administration: Responsible for integration, maintenance and support of specific internal applications related to health care quality improvement, data administration and analysis. Work in conjunction with Information Systems resources to successfully submit quality measure data to regulatory agencies (e.g., NCQA, CMS, Med-QUEST) within required parameters. Ensure that quality measure data is complete and accurate by implementing effective controls and validation activities. Develop project plans for implementation to lead and coordinate problem tracking, resolution and verification testing as needed. Analyze existing applications and/or design to complete data analyses and reporting required to meet goals. 3. Reports and Presentations: Translate data into actionable information using tables, graphs, charts, written reports and presentations. Design and implement reports to provide internal and external stakeholders with actionable data that supports operational improvements. Develop and document reporting tools to support, track, analyze and evaluate quality improvement activities. Ensure reports and presentations are accurate, concise, clearly stated and appropriate for internal and external audiences and all levels of staff. 4. Project Management: Work with cross-departmental teams to deliver projects. Collaborate with other staff and management to complete assigned duties and objectives, facilitate communication, and resolve problems and issues quickly and positively. Clearly and concisely communicate project objectives, tasks, status and results. 5. Performs all other miscellaneous responsibilities and duties as assigned or directed.
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Job Type
Full-time
Career Level
Mid Level