Quality Data Consultant, VBC

The Quality Data Consultant also evaluates quality reporting methodologies, workflows, and processes; recommends and supports implementation of sustainable improvements; and serves as a resource regarding quality measurement requirements, data integrity, reporting methodology, and value-based care performance.e. Responsibilities: Essential Functions: • Independently evaluates recurring membership, utilization, patient outcome, and quality performance information across multiple systems; determines appropriate data sources and analytical approaches; and interprets results to identify material trends, risks, and opportunities requiring operational or performance improvement action.

Position Summary:

Schedule: M-F 8am-5pm Onsite

Location: Winter Park, FL 

 

About Orlando Health:

 

At Orlando Health, we are ordinary people with extraordinary individuality, working together to bring help, healing and hope to those we serve. By daily embodying our over 100-year legacy, we reinforce our reputation as a trusted and respected healthcare organization that delivers professional and compassionate care to our patients, families and communities. Through our award-winning hospitals and ERs, specialty institutes, urgent care centers, primary care practices and outpatient facilities, our dedicated team members serve communities that span Florida’s east to west coasts, Central Alabama and Puerto Rico.

 

Orlando Health is committed to providing you with benefits that go beyond the expected, with career-growing FREE education programs and well-being services to support you and your family through every stage of life. We begin your benefits on day one and offer flexibility wherever possible so that you can be present for your passions. “Orlando Health Is Your Best Place to Work” is not just something we say, it’s our promise to you

 

Position Summary:

 

The Quality Data Consultant serves as a subject matter consultant supporting quality performance, value-based care, and population health initiatives across assigned Value Based Care and Population Health arrangements. The Quality Data Consultant independently evaluates complex quality, utilization, patient outcome, and performance data to identify trends, risks, performance gaps, and opportunities for improvement. The position interprets findings and evaluates their operational, contractual, financial, regulatory, and quality implications; develops recommendations to address identified opportunities and risks; and provides analytical consultation to operational, clinical, payer, provider, and leadership stakeholders to support organizational decision-making and performance improvement. The Quality Data Consultant also evaluates quality reporting methodologies, workflows, and processes; recommends and supports implementation of sustainable improvements; and serves as a resource regarding quality measurement requirements, data integrity, reporting methodology, and value-based care performance.e.

Responsibilities:

Essential Functions:

• Possesses a clear understanding of standard measure specifications, such as HEDIS and CMS, and maintains working knowledge of individual Value Based Care contract measures and reporting requirements.
• Determines and utilizes appropriate clinical, administrative, and reporting data sources and analytical methods to evaluate quality and performance questions. Develops analytical outputs, visualizations, and presentations that effectively communicate findings, business implications, risks, and recommendations to stakeholders.
• Evaluates quality metric performance and member-level information across assigned provider populations to identify performance gaps, data integrity concerns, and opportunities for improvement. Determines appropriate validation and analytical approaches and utilizes targeted chart review and data validation activities to investigate findings and support accurate reporting to insurance payers.
• Independently evaluates recurring membership, utilization, patient outcome, and quality performance information across multiple systems; determines appropriate data sources and analytical approaches; and interprets results to identify material trends, risks, and opportunities requiring operational or performance improvement action.
• Independently analyzes and interprets complex data to address internal and external business requirements, evaluates alternative approaches when data or reporting requirements are unclear, and develops recommendations that support decision-making, process improvement, quality performance, and effective program implementation.
• Investigates and evaluates data collection and reporting discrepancies within ELLiE Healthy Planet, the Comprehensive Health Record (CHR), and other applicable systems; collaborates with technical and operational stakeholders to determine root causes and recommends appropriate resolutions to support accurate quality measurement and reporting.
• Utilizes analytical, reporting, and presentation technologies to evaluate complex information, communicate findings, explain business implications, and present recommendations to operational, clinical, payer, and leadership stakeholders.
• Provides analytical oversight of assigned payer quality performance reporting and independently evaluates results against contractual, regulatory, and organizational requirements. Identifies material performance risks and opportunities, presents findings and recommendations to leadership, and collaborates with stakeholders to address identified issues.
• Develops and evaluates performance tracking methodologies to monitor quality outcomes, identify emerging performance risks, assess improvement opportunities, and support leadership decision-making regarding quality initiatives.
• Evaluates gaps in care and other performance indicators from internal and external sources to identify trends, assess potential causes of underperformance, and develop recommendations for targeted action plans and performance improvement strategies.
• Investigates complex data discrepancies and reporting variances by evaluating information across multiple systems and sources, determines appropriate corrective actions, and collaborates with stakeholders to implement sustainable data quality improvements.
• Performs targeted clinical chart review and abstraction when necessary to investigate quality performance, validate reporting methodology, resolve data discrepancies, assess measure compliance, and inform quality improvement recommendations.

• Develops and interprets member-level analyses to identify opportunities for targeted patient engagement and performance improvement strategies and provides recommendations regarding opportunities to achieve applicable quality and Value Based Care objectives.
• Leads or independently manages assigned analytical and quality improvement projects by defining analytical requirements, evaluating available data, identifying findings and risks, developing recommendations, and supporting implementation and evaluation of results.
• Serves as a quality data subject matter resource in payer and stakeholder meetings; evaluates questions and reporting requirements, provides analytical interpretation of performance results and methodologies, and makes recommendations regarding data quality, reporting requirements, and quality improvement opportunities.
• Evaluates existing quality reporting and operational workflows to identify opportunities to improve accuracy, efficiency, sustainability, and performance; independently recommends, tests, and refines workflow modifications and process improvements.
• Embraces, communicates, and promotes effective change to improvement team dynamics and day-to-day workflows.
• Performs other duties as assigned to support the health system’s overall population health and value-based care team objectives.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA, and other federal, state, and local standards.
• Maintains compliance with all Orlando Health policies and procedures.

 

Other Related Functions:

• Maintains current knowledge of healthcare quality, value-based care, population health, payer requirements, quality measurement methodologies, regulatory developments, and industry trends and evaluates their potential implications for organizational quality performance.
• Works independently and collaboratively across multidisciplinary teams and organizational levels, including temporary project teams, and effectively manages competing priorities and assignments requiring independent evaluation, judgment, and follow-through.
• Demonstrates advanced knowledge of EHR platforms, clinical applications, data documentation practices, and quality reporting workflows, including the ability to evaluate how clinical documentation and data capture affect quality measurement and organizational performance.
• Handles confidential material in a professional and responsible manner.

Qualifications:

Education/Training:

• Bachelor's degree in Healthcare Administration, Public Health, Business Administration, Health Sciences, Healthcare Informatics, Data Analytics, or a related field preferred.

Licensure/Certification:

• None.

 

Experience:

• Three (3) years of professional experience in healthcare quality, value-based care, population health,
healthcare analytics, payer performance, quality improvement, or a related field preferred.
• Demonstrated experience independently analyzing healthcare performance data, interpreting quality
measures, identifying performance improvement opportunities, evaluating data integrity, and communicating
analytical findings and recommendations to operational, clinical, payer, or leadership stakeholders required.
• Proficiency in Microsoft Excel, PowerPoint, and other analytical and reporting tools required. Experience with
electronic health records, quality reporting platforms, HEDIS and CMS quality measures, payer reporting
requirements, and value-based care arrangements preferred.