Senior Quality Analyst (Hybrid)

CareFirst•Baltimore, MD

3d•Hybrid

About The Position

The Senior Quality Analyst is responsible for the most complex work of the team in defining, measuring, analyzing, and evaluating population health, while prioritizing, developing, and operationalizing innovative initiatives to improve the quality of care and experience, resulting in industry-leading outcomes at a population level. Independently responsible and accountable for ensuring that their work aligns with and helps to achieve the organization's vision as it relates to population health, quality, and member experience. Serves as peer mentor within the team. We are looking for an experienced professional in the greater Baltimore/Washington metropolitan area who is willing and able to work in a hybrid model. The incumbent will be expected to work a portion of their week from home and a portion of their week at a CareFirst location based on business needs and work activities/deliverables that week.

Requirements

Bachelor's Degree, Associates in population health, public health, healthcare administration, business administration, health policy, economics, statistics, mathematics, data science, or a related field OR in lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
5 years professional experience in a business environment (public health, health insurance, management consulting fields preferred); evidence of progressing levels of responsibility.
Expertise in qualitative and quantitative data analyses and presentations.
End-to-end experience designing, developing, and implementing innovative strategies to improve population health.
Experience self-managing multiple projects and provide regular status reports.
Ability to conduct advanced analytics using SQL, Python, R, or similar.
Fluent in the use of Microsoft tools including Excel, Word, Power Point and Outlook.
Expertise with healthcare claims, survey, clinical, and health data.
Ability to mentor and guide other team members and lead initiatives in a matrix environment.
Remote electronic medical record experience.
Ambulatory practice experience required.
Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.
Must be eligible to work in the U.S. without Sponsorship

Nice To Haves

RN-BC - Certified General Nursing Practice Licensed Medical Professional
Certification in Quality or Process Improvement Methods.
Direct experience with accreditation, HEDIS, CAHPS and other quality related activities a healthcare related environment and/or payor organization.
Data analytics experience working with large data sets to answer clinical, operational, or business questions; prior experience with healthcare data expected.

Responsibilities

Act as the organization's subject matter expert in population health, measurement science, accreditation, and quality improvement.
Utilizes the framework of NCQA Accreditation to accomplish and document the work products.
Define, measure, and document the performance of the health plan in facilitating quality healthcare, positive outcomes, and excellent experience for members.
Analyze and evaluate health plan performance using qualitative and quantitative methodologies, producing actionable and insightful reports and visualizations addressing population health quality opportunities.
Prioritize, develop, and operationalize these opportunities in collaboration with other areas of the organization into innovative programs and initiatives
Mentor team members and provides guidance on most complex work efforts.
Assist with special projects and/or department initiatives that require thought leadership and subject matter expertise in a consultative manner.