Lead Quality Data Analyst - Remote

EmblemHealth

United States

United States

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Summary of Job Lead and develop meaningful insights, actionable analytics and applicable plans and /or corrective actions through appropriate advanced statistical and/or modeling analyses. Incorporate diverse data sources across internal and external platforms to continuously improve the plan's healthcare qualitymetric performance (HEDIS/QARR/Star/Accreditation) to drive quality improvement initiatives/projects. Identify improvement opportunities and provide guidance for needed changes. Provide support in the satisfaction of internal and external requirements in support of EmblemHealth's HEDIS/QARR metric improvement and reporting responsibility. Prepare and present analytical dashboards and data to key stakeholders to support strategic decision making. Responsibilities Lead the development of complex and/or advanced statistical/modeling analyses of quality metrics for Medicare, State Sponsored Programs, and other populations. Develop and maintain quality dashboards and measure profiles utilizing data visualization tools. Analyze monthly rate reports and stratify data to identify statistically significant trends. Perform monthly rate/impact /trending analysis and recommend corrective actions to meet quality targets. Conduct evaluation studies and root-cause analyses to identify improvement area(s) and understanding of the marketplace. Evaluate program effectiveness for complex quality improvement projects. Provide analytical and evaluation guidance to internal department for simple projects. Generate population or targeted profiles with frequency, categorical, and spatial analyses. Perform exploratory and in-depth data analyses for assigned measure/population and develop complex predictive models utilizing independent variables and programming language. Develop customized models and scenario analyses to monitor and review projected measure scores/incentive results through the year. Lead and take corrective actions to meet established goals and/or overall quality metric goals. Create, design, and implement new analytics tools and visualizations to supplement and support decision-making for departmental activities. Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues. Maintain up-to-date knowledge and understanding of HEDIS/QARR/Star measure technical specifications. Support quality specific interoperability efforts. Support quality specific regulatory needs. Collaborate with internal quality management teams to assist on quality improvement initiatives. Provide analytical and technical support for design, development and maintenance of quality improvement and wellness initiatives. Develop additional elements to prepare plan-specific and provider-specific reports/information related to quality, services, and other areas.
Qualifications Bachelor's Degree in analytical/quantitative field including healthcare management, finance, business, mathematics, engineering, applied stats/economics, or any other related fields. Master's Degree (Preferred) 5 - 8+ years of relevant, professional work experience (Required) 5+ years of experience in any analytical field (Required) 3+ years of managed care/healthcare experience (Preferred) Proficient in Microsoft Office - Word, PowerPoint, Excel, Access ( (Required) Advanced experience with relational database applications - SAS, R, SQL, or others (Required) Experience with improving/automating processes using programming languages/software - Python, VBA, R, SAS, C++, etc. (Required) Experience with and proficient in statistical software/programs - SAS, R, Stata, Minitab or others (Required) Experience with and proficient in data visualization tools - Power BI, Tableau (Required)) Knowledge of HEDIS & QARR reporting processes and Medicare Stars (Preferred) Strong communication skills - verbal, written, presentation, interpersonal (Required)
Additional Information
Requisition ID: 1000002937
Hiring Range: $77,760-$149,040

United States

Sprachkenntnisse

English

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