Senior Quality Data Analyst - Remote

Summary of Job

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)