Quality Measurement & Improvement Analyst at Independent Health
Buffalo, NY — full-time
The Quality Measurement and Improvement Analyst–Senior will integrate data from multiple sources (claims, membership, provider, risk scores, EMR, ADT, etc.) to develop reports and complex analyses to understand and explain quality measure trends and the drivers for the trends. The Quality Measurement and Improvement Analyst–Senior will collaborate with key business units to identify areas of opportunity to close quality gaps in care and to forecast quality measure trends. The Quality Measurement and Improvement Analyst–Senior will also work with the Quality Workgroup team on initiatives to improve specific quality measure rates as identified in various performance improvement programs from regulatory bodies. The Quality Measurement and Improvement Analyst–Senior will also provide critical support in the annual HEDIS and QARR data submissions and will help the Manager–Quality Measurement and Improvement Analytics respond to HEDIS auditor concerns as needed. Qualifications Bachelor’s degree in a quantitative/research discipline required. Master’s preferred. An additional four (4) years of experience will be considered in lieu of degree. Five (5) years of analytics experience required, to include experience in SAS or SQL. Experience in a managed health care environment preferred. Expert knowledge of Independent Health EDW, Health Rules, Beacon, and Medicaid FFS data and structures preferred. Expert knowledge of Healthcare concepts and Healthcare data, for example, CPT, HCPCS, DRG, diagnosis codes, etc. Strong understanding of HEDIS and QARR technical measure specifications and ability to create member level chase reports when requested. Familiarity with NCQA certified HEDIS/QARR measure software (Cotiviti Quality Reporter preferred). Working knowledge of LOINCs, SNOMEDs, CVX, other less common healthcare data codes and demonstrated ability to utilize these types of codes in reporting as needed. Demonstrated ability to profile and integrate novel data sources into complex reporting. Experience with cloud computing (AWS Athena, Redshift, SageMaker preferred). In lieu of specific healthcare experience, a candidate can possess relevant experience dealing with large and structured datasets. Fundamental knowledge of data mining concepts (courses or certification). Expert knowledge of software used for statistical analysis, for example, SQL, SAS, R, Python, etc. Expert knowledge of reporting tools, for example, Excel, SAS Visual Analytics, Qlik Sense. Ability to translate customer requirements into reports/analyses and frame questions that create value for the business partners. Ability to present and communicate complex output and statistical analysis in a meaningful way that meets the needs of and is easily understood by the business partners. Ability to lead and work with minimal supervision on multiple -complex projects at the same time. Excellent problem-solving, interpersonal, analytical, and critical thinking skills. Ability to work with team