Quality Improvement Analyst Senior (US)

Elevance Health • Tampa, FL

8h • Hybrid

About The Position

Quality Improvement Analyst Senior- Analysis Locations: The selected candidate must reside within a reasonable commuting distance of the designated posting location(s): Tampa, FL Hybrid 1 : This role requires associates to be in-office 1 - 2 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Please note that per our policy on hybrid/virtual work, candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless accommodation is granted as required by law. The Quality Improvement Analyst Senior is responsible for assisting with the annual HEDIS medical record collection process is implemented timely and accurately. How you will make an impact: Interfaces with multiple enterprise departments and external vendor to annually field a new HEDIS pursuit application that has been tested for new technical specifications and quality checked that all data feeds are valid and report accurate information from the field medical record abstractions. Creation of a web-based application that is compliant with the current year’s NCQA technical specifications measures. Analysis of the data base is conducted daily to ensure the final rate output achieves the NCQA auditors, approval for that reporting year’s hybrid rates to maintain NCQA accreditation and multiple state contract requirements. Performs quality checks for multiple external data feeds to application, responsible to coordinate information exchange with external vendors and collaborative partners, train and monitor multiple end-users nationally through development of training manuals and classes for application end users. Track national field staff data collection daily to ensure annual project accreditation and regulatory submission deadlines are met, participate in onsite accreditation audits , produce and report valid HEDIS measure rate reports to NCQA certified auditor, serve as data resource for internal customer developed requests for ad hoc HEDIS statistics and trended data reports.

Requirements

• Requires a BS/BA degree in a related field, 3-5 years of data analysis, NCQA accreditation standards and HEDIS technical specifications; or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

• Experience navigating and operating Cotiviti’s HEDIS software highly preferred.
• Proficient in using SQL for querying and analyzing data strongly preferred.

Responsibilities

• Interfaces with multiple enterprise departments and external vendor to annually field a new HEDIS pursuit application that has been tested for new technical specifications and quality checked that all data feeds are valid and report accurate information from the field medical record abstractions.
• Creation of a web-based application that is compliant with the current year’s NCQA technical specifications measures.
• Analysis of the data base is conducted daily to ensure the final rate output achieves the NCQA auditors, approval for that reporting year’s hybrid rates to maintain NCQA accreditation and multiple state contract requirements.
• Performs quality checks for multiple external data feeds to application, responsible to coordinate information exchange with external vendors and collaborative partners, train and monitor multiple end-users nationally through development of training manuals and classes for application end users.
• Track national field staff data collection daily to ensure annual project accreditation and regulatory submission deadlines are met
• Participate in onsite accreditation audits
• Produce and report valid HEDIS measure rate reports to NCQA certified auditor
• Serve as data resource for internal customer developed requests for ad hoc HEDIS statistics and trended data reports.

Benefits

• We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level