Senior Analyst, Population Health and HEDIS Analytics

CVS Health•Work At Home-Illinois, IL

19h•$46,988 - $112,200

About The Position

Provides consultation to the ABHIL Quality Department, stakeholders, and National data teams based on analysis and identification of key drivers of results. Uses data to identify clinical trends, analyze high-cost claimants, population health and other clinical trends, evaluate performance results, monitor engagement, and collaborate on opportunities for improvement. Utilizes statistical analysis, data visualization tools, and database queries to identify trends, patterns, and opportunities for quality improvement. Develops and maintains performance metrics and dashboards to track and report on patient safety, clinical effectiveness, patient experience, and compliance with quality standards. Contributes to quality improvement projects and initiatives by providing data-driven insights and recommendations. Collaborates with cross-functional teams to design and implement evidence-based practices, care protocols, and process improvements. Assists in conducting audits and performing chart reviews to monitor compliance with regulatory requirements and quality standards. Prepares reports and presentations on quality metrics, performance trends, and improvement initiatives. Creates reports that encourage transparency by communicating findings to stakeholders, including leadership, providers, and other relevant teams in a comprehensive manner. Collaborates with various stakeholders to integrate new quality improvement efforts and facilitate the resolution of care coordination issues. Assists in developing and delivering training programs on quality management principles, best practices, and data visualization tools.

Requirements

Advanced Excel skills (e.g., formulas, pivot tables, slicers, visualizations)
Proficient Power BI skills (e.g., basic data modeling, data import, DAX)
Advanced SQL Server Management Studio and best practices in commenting and writing succinct SQL code to perform ETL of large SQL databases
Advanced skills at using AI engines (e.g., Microsoft Copilot) to optimize SQL coding and analytics
Advanced SQL database table design skills (e.g., data dictionary, data validation)
Advanced data peer review skills to always ensure that data is valid, accurate, and complete
Advanced geospatial intelligence skills (e.g., choropleth, heatmaps, suitability analysis, mileage calculation, routing, caseload optimization, custom HEDIS gap closure interventions, custom population health management interventions, new member characteristics predictive models, vector data, raster data, geocoding, geoprocessing, map composition, custom labels, map books, data models) using ArcGIS Pro or QGIS
Proficient in HEDIS measures and a basic understanding of NCQA stars
Advanced population analytics & profiling (e.g., SDOH, IP, ER, OP, Dx, Rx, HEDIS, SOGI, GeoIntel)
Excellent organizational skills (e.g., Microsoft SharePoint, Microsoft Teams, Microsoft Planner)
Independent management of data analytics requests from specing to output generation
In-depth root cause analysis into data variation and data quality issues
In-depth data analyses re: HEDIS performance, population health management, SDOH disparities
Training courses in geospatial analytics (or equivalent geospatial work experience)
Bachelor’s Degree

Nice To Haves

Master's Degree
Positive attitude
Excellent attention to detail
Excellent verbal and written communication skills
Excellent cross-functional collaboration skills
Ability to deal with ambiguity and work in a fast-paced environment
Excellent process improvement skills
Excellent standardization skills
Ability to adjust data analytics communication based upon the data literacy levels of audience

Responsibilities

Provides consultation to the ABHIL Quality Department, stakeholders, and National data teams based on analysis and identification of key drivers of results.
Uses data to identify clinical trends, analyze high-cost claimants, population health and other clinical trends, evaluate performance results, monitor engagement, and collaborate on opportunities for improvement.
Utilizes statistical analysis, data visualization tools, and database queries to identify trends, patterns, and opportunities for quality improvement.
Develops and maintains performance metrics and dashboards to track and report on patient safety, clinical effectiveness, patient experience, and compliance with quality standards.
Contributes to quality improvement projects and initiatives by providing data-driven insights and recommendations.
Collaborates with cross-functional teams to design and implement evidence-based practices, care protocols, and process improvements.
Assists in conducting audits and performing chart reviews to monitor compliance with regulatory requirements and quality standards.
Prepares reports and presentations on quality metrics, performance trends, and improvement initiatives.
Creates reports that encourage transparency by communicating findings to stakeholders, including leadership, providers, and other relevant teams in a comprehensive manner.
Collaborates with various stakeholders to integrate new quality improvement efforts and facilitate the resolution of care coordination issues.
Assists in developing and delivering training programs on quality management principles, best practices, and data visualization tools.