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QUALITY HEALTHCARE ANALYST II

Beacon Health Options • US-Nationwide

Posted 1 month ago

Job Snapshot

Full-Time
Degree - Graduate Degree
Other Great Industries
Health Care, QA - Quality Control

Job Description

The Quality Healthcare Analyst II will be responsible for development and implementation of methodologies to monitor and trend performance on key clinical and quality indicators and to identify improvement opportunities.  The activities will require strong statistical and programming skills with complex data sets.  The position is responsible for assisting regions in developing measurement plans and to assist them in monitoring and reporting uniform metrics.  The Quality Analyst II will be tasked with developing root cause analyses and working with stakeholders to share and interpret data through to action planning and evaluation

Duties and Responsibilities

  • Play a lead role in the development and implementation of analytic capabilities for the Corporate Quality Department.
  • Research, report, and data analyze focusing on medical, behavioral health and pharmacy claims data.
  • Work with Reporting/Knowledge Management, the Analytics Innovation Center (AIC) and application development staff to develop specifications and business logic for analytics needs for the department.
  • Develop Business Requirements Documents for the production of National/State Quality metrics such as HEDIS and QARR measures.
  • Act as the Quality lead on ongoing and annual HEDTS documents and submissions for delegated Health Plans.
  • Responsible for keeping track of HEDIS performance standards for delegated health plans and sharing that data with key Beacon staff.
  • In collaboration with the VP Quality, and VP Performance Measurement and Improvement, create data dictionary related to HEDIS and other Quality metrics to standardize data production, interpretation and to maintain data integrity. Develop effective means to document data sources.
  • Produce weekly/monthly data for QIA teams as needed in order to support the CQI process. Develop action plans and using the Plan-Do-Study-Model, course correct on intervention not having the intended impact.
  • Responsible for supporting Regional PIPs and Region and Corporate QIAs from root cause analysis through evaluation.
  • Provide technical assistance to Regional Quality Analysts in the development, refinement, and ongoing management of daily analytic and reporting operations to inform Regional Quality Department activities and deliverables.
  • Develop a quality dashboard for all program activities that aggregates Regional results to corporate level. 
  • Research, report, and data analyze focusing on NCQA and URAC accreditation activities.
  • Responsible for analysis and reporting on corporate wide performance improvement activities, and presenting results to senior leadership.
  • QAs data and ensures data integrity.
  • Creatively works with data to develop new measures.
  • Oversee and manage HEDIS Roadmap deliverables;
    • Create and maintain HEDIS Roadmaps deliverables tracker.
    • Collaborate with Beacon SME’s on roadmap completion and identify regional account leads to support client roadmap requests.
    • Create roadmap files with all required attachments, and deliver them directly to the clients or Account Partnership staff cross the company.
  • Oversee and manage HEDIS Rates deliverables;
    • Create and maintain HEDIS Rate deliverables tracker.
    • Collaborate with Beacon SME’s on rate production needs including interpretation of measure specks to inform HEDIS code, as well as any changes to the measure guidelines.
    • In collaboration with the Corporate Quality Analytics Manager, maintain current year HEDIS business requirement documents and communicate changes to the Quality Regional Leads related to the BH measures.
    • Development and maintenance of SOP’s related to HEDIS measures like PSV (Primary Source Verification) Process for FUH measure.
    • Collaborate with other team members on creation of Quality Control related SOP’s.
    • Provide PSV training for all Beacon regions related to NSSD (Non-Standard Supplemental Data Collection).

Minimum Qualifications

Education:  Master's Degree in behavioral health, health care administration, epidemiology, biostatistics, or related field.

Licensure: None

Relevant Work Experience: Three or more years' experience in healthcare, behavioral health preferred and three or more years' experience in advanced data analysis, database administration and report writing. Experience with quality improvement activities preferred.

Knowledge, Skills & Abilities: The ideal candidate has strong data analysis, evaluation, and reporting skills and the ability to work on cross-functional teams to support quality management/data analysis needs

  • Strong communication skills, both oral and written
  • Excellent organizational skills required to work on multiple projects / clients simultaneously
  • Must be adaptable to frequent change utilizing effective decision-making
  • Ability to motivate a team or individual to achieve desired outcomes
  • Attention to detail, timely follow through with ability to consistently meet deadlines
  • Proficient with Microsoft Office Suite

TO APPLY

Click below on “Apply for this Position” to create a profile and apply for the position

Beacon Health Strategies, LLC, a Beacon Health Options Company, is proud to be an Equal Opportunity and Affirmative Action Employer as well as a Drug Free and Tobacco Free Work Environment. EOE/AA/M/F/Veterans/Disabled

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#GD

PM16

$REM

Job ID: 56478
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