Quality Intelligence Program Consultant

Department: 13577 Value Enablement Services - Value Based: Quality

Status:

Full time

Benefits Eligible:

Yes

Hou rs Per Week:

40

Schedule Details/Additional Information:

Fulltime, Dayshift from Monday - Friday 9am - 5pm. This role will be fully remote.

Fully Remote Role from these states: AL, AK, AR, AZ, DE, FL, GA, IA, ID, IL, IN, LA, KS, KY, ME, MI, MO, MS, MT, NC, ND, NE, NH, NM, NV, OH, OK, PA, SC, SD, TN, TX, UT, VA, WI, WV, WY

No relocation and no sponsorship or transfer of visa for this position now or in the future.

Pay Range:

$38.20 - $57.30

Major Responsibilities:

• Contributes to system-wide Quality/Health Outcomes measure development and definitions, goal setting, project improvement activities and work groups for AAMG and EPH. Keeps current on external reporting programs, associated measures, and best practices in order to ensure internal priorities align with external environment and demands. Maintains programming specifications and code lists for all quality measures in value-based agreements and internal reporting and partners with other data professionals to ensure timely communication of critical updates.
• Leads the development of enterprise-wide reports, processes, workflows, tools, and initiatives designed to improve health outcomes. Leads the development and adoption of processes and mechanisms for accurate quality data collection, analysis and reporting. Manages the interpretation, analysis, and communication of Quality data by engaging professionals in own department and leaders of other collaborating departments to drive improvements.
• Participates in the development of reports, files, and databases used for internal and external reporting. Ensures accuracy and optimization of quality data and is a resource for business intelligence, data analysis, and workflows supporting Quality initiatives and data integrity. Performs data validation to assure data accuracy and integrity (related to data feeds, measure mapping, etc.) and assists in resolving deficiencies.
• Helps develop readily accessible and intuitive quality intelligence solutions (dashboards, dynamic reports, data visualizations, etc.) to deliver actionable information to multiple end users (clinicians, leaders, executives etc.). Leads Quality Intelligence meetings with key stakeholders. Tracks and trends value-based payer quality performance data and analyzes improvement opportunities to inform the department strategy.
• Meets with and serves as the contact for external payer partners and internal partners for assigned area of oversight. Manages and leads system improvement efforts, develops quality strategies related to internal and external quality measures and payer data feeds, and serves as the subject matter expert.
• Develops improved Electronic Health Record (EHR) tools to ensure complete data capture and to support the strategic priorities related to value-based agreements in collaboration with key functional departments and leadership.

Licensure, Registration and/or Certification Required:

• None Required.

Education Required:

• Bachelor’s degree in Health Care Administration, Project Management, Quality, Engineering, or related field.

Experience Required:

• Typically requires 5 years in Health Care Administration, Project Management, Quality Intelligence, or related field.

Experience Preferred:

• HEDIS/NCQA Payor experience

Knowledge, Skills & Abilities Required:

• Knowledge of quality improvement methodologies, tools, and measures.
• Project Management methodology and tools.
• Statistical techniques to support analysis and interpretation of data.
• Ability to create reports, graphs, and other visual presentation materials, and effectively maintain statistical data.
• Excellent analytical and statistical skills with ability to analyze complex data, make inferences, and validate conclusions
• Team and meeting facilitation techniques and tools.
• Strong written and oral communication skills.
• Experience with Microsoft Office Suite (Word, Excel, PowerPoint, Outlook, Teams).
• Demonstrates knowledge of value-based agreements, Accountable Care Organizations (ACOs), integrated health care operations and value based health care models. Knowledge of Information system tools, report programming, and measure development. Knowledge of Information system tools, report programming, and measure development. Knowledge of CMS, NCQA HEDIS, MA Stars and evidence-based guidelines.

Physical Requirements and Working Conditions:

• Ability to sit for extended periods of time.
• Exposed to normal office environment.
• Operates all equipment necessary to perform the duties of the job.

This job description indicates the general nature and level of work expected of the incumbent. It is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities required of the incumbent. Incumbent may be required to perform other related duties.

Our Commitment to You:

Advocate Health offers a comprehensive suite of Total Rewards: benefits and well-being programs, competitive compensation, generous retirement offerings, programs that invest in your career development and so much more – so you can live fully at and away from work, including:

Compensation

• Base compensation listed within the listed pay range based on factors such as qualifications, skills, relevant experience, and/or training

• Premium pay such as shift, on call, and more based on a teammate's job

• Incentive pay for select positions

• Opportunity for annual increases based on performance

Benefits and more

• Paid Time Off programs

• Health and welfare benefits such as medical, dental, vision, life, and Short- and Long-Term Disability

• Flexible Spending Accounts for eligible health care and dependent care expenses

• Family benefits such as adoption assistance and paid parental leave

• Defined contribution retirement plans with employer match and other financial wellness programs

• Educational Assistance Program

Note: Eligibility for programs listed above may depend on your FTE or status (e.g., full-time, part-time, per diem, temporary, etc.); please ask a Recruiter for more information during an interview.

About Advocate Health

Advocate Health is the third-largest nonprofit, integrated health system in the United States, created from the combination of Advocate Aurora Health and Atrium Health. Providing care under the names Advocate Health Care in Illinois; Atrium Health in the Carolinas, Georgia and Alabama; and Aurora Health Care in Wisconsin, Advocate Health is a national leader in clinical innovation, health outcomes, consumer experience and value-based care. Headquartered in Charlotte, North Carolina, Advocate Health services nearly 6 million patients and is engaged in hundreds of clinical trials and research studies, with Wake Forest University School of Medicine serving as the academic core of the enterprise. It is nationally recognized for its expertise in cardiology, neurosciences, oncology, pediatrics and rehabilitation, as well as organ transplants, burn treatments and specialized musculoskeletal programs. Advocate Health employs 155,000 teammates across 69 hospitals and over 1,000 care locations, and offers one of the nation’s largest graduate medical education programs with over 2,000 residents and fellows across more than 200 programs. Committed to providing equitable care for all, Advocate Health provides more than $6 billion in annual community benefits.