This is a fully remote position, open to applicants in United States.

📋 Description

• Conduct analyses and forecasts on quality performance across various measures, contracts, markets, and providers, pinpointing significant trends, risks, and opportunities.

• Create dashboards, analyses, and executive summaries that effectively convey performance drivers and suggest actionable recommendations.

• Interpret CMS, NCQA, and PQA quality measure specifications into precise reporting requirements while monitoring related program modifications.

• Ensure the integrity of quality data, including the validation of supplemental data submissions, payer reconciliations, and providing audit support.

• Collaborate with clinical, operational, analytics, technology, and health plan teams to address issues and facilitate targeted interventions.

• Independently manage multiple priorities while ensuring accountability for accurate and timely deliverables.

• Report directly to the Director of Quality Operations.

• Undertake additional duties as assigned.

⛳️ Requirements

• A Bachelor’s degree in analytics, health informatics, public health, business, or a related discipline.

• Over 3 years of experience in consulting, healthcare analytics, or population health, including familiarity with HEDIS measures, Medicare Advantage Stars, or Medicare ACO quality programs.

• Advanced skills in Microsoft Excel and PowerPoint.

• Proficient in SQL, including the ability to query, join, and validate large datasets.

• Experience in analyzing claims, clinical, supplemental, or care-gap data.

• Knowledge of quality measure specifications, performance forecasting, and data-validation techniques.

• Preferred experience with Databricks, Power BI, Tableau, or a similar data visualization platform.

• Training or certification in data analytics, healthcare quality, or project management is preferred.

• A graduate degree in a relevant field is preferred.