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À propos
Support the Quality Management department in the development and maintenance of a monitoring and reporting structure for data reports and analysis related to the HEDIS-QARR project, pharmacy adherence initiatives, and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Provide analysis of HEDIS-QARR projects, pharmacy adherence initiatives, and other performance improvement initiatives related to Medicare Stars and Medicaid QIA. Develop meaningful insights and actionable analytics using advanced statistical and/or modeling analyses to drive quality and STARS performance.
Responsibilities Analyze monthly rate reports and stratify data to identify statistically significant trends. Evaluate effectiveness of complex quality improvement projects established for all Medicare and state-sponsored programs. Create reports to track, monitor and report on provider and network-wide quality performance, including performance towards Medicare Stars and NYSDOH quality goals. Perform exploratory and in-depth data analyses for assigned measure/population and develop complex predictive models utilizing independent variables and programming language. Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues. Provide analytical and technical support in the design, development and maintenance of quality improvement and wellness-based initiatives. Work with various teams in Quality Management to develop needed tools to track, trend and directly impact measures results related to Quality Scores. Perform regular rate/impact /trending analysis and recommend corrective actions to meet quality targets. Maintain up-to-date knowledge and understanding of HEDIS/QARR/Star measure technical specifications. Support quality specific interoperability efforts. Support quality specific regulatory needs. Qualifications
Bachelor's Degree in an analytical/quantitative field (healthcare management, finance, business, mathematics, engineering, applied stats/economics, or related). Master's Degree (Preferred) 4 - 6+ years of relevant, professional work experience in an analytical role (Required) 2+ years of managed care/healthcare experience (Preferred) Proficient in MS Office - Word, PowerPoint, Excel, Access (Required) Advanced experience with relational database applications - SAS, R, SQL, or others (Required) Experience with improving or 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) Familiarity with Business Intelligence tools - Tableau, Power BI (Preferred) Knowledge of HEDIS and Medicare Stars reporting processes (Preferred) Strong communication skills - verbal, written, presentation, interpersonal (Required)
Compétences linguistiques
- English
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