Transformation Analyst III

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

📋 Description

• Oversee cross-departmental initiatives utilizing financial and/or clinical analytics to provide strategic recommendations for transformation, health, and quality management.

• Execute quality improvement initiatives informed by analytics to align with IEHP compliance standards, strategic objectives, and programs.

• Collaborate with stakeholders to design and implement technical analyses.

• Assess current data sources for efficacy.

• Develop visualization tools for data representation.

• Propose strategic decisions and action plans for business units.

• Manage projects that include study development, data gathering, data analysis, policy interpretation, and policy updates.

• Serve as the primary liaison to support operational and quality improvement projects, engaging with leadership teams across the organization and, as necessary, hospital and ancillary providers.

• Integrate and prepare diverse datasets for analysis.

• Design analytical databases and visualization environments.

• Present findings adhering to IEHP business guidelines and reporting requirements.

• Incorporate goals from the IEHP Quality Program, including HEDIS, CAHPS, and NCQA Accreditation.

⛳️ Requirements

• A minimum of six (6) years of experience in study development, writing, and analysis within healthcare (quality improvement, patient/provider services, healthcare finance, care management, or related fields) is required.

• Proven experience working with complex data systems and datasets.

• Experience with electronic medical records, documentation, and reporting/analysis is required.

• A master's degree in mathematics, statistics, computer science, information systems, business administration, healthcare, or a related field from an accredited institution is required.

• Alternatively, a bachelor’s degree in mathematics, statistics, computer science, information systems, business administration, healthcare, or a related field from an accredited institution along with a minimum of two (2) years of experience in a hospital or health plan setting is required; this experience is in addition to the minimum years specified above.

• Certifications such as PMP, Lean Six Sigma, certified professional in Healthcare Quality, or other relevant credentials are preferred.

• A valid California Driver’s License is preferred.

• Advanced understanding of quality compliance standards and internal/external healthcare/hospital and business operations.

• Familiarity with available data sources, data systems, and relevant data analysis criteria.

• Knowledge of statistical methods, data analysis techniques, and research methodologies.

• Understanding of relational database structures and database design.

• Awareness of departmental relationships and external partnerships that support daily operations.

• Familiarity with concepts, practices, and procedures in a healthcare environment is preferred.

• Proficiency in medical terminology and understanding of managed care, claims payment processes, and insurance terminology is required.

• Strong analytical skills with a focus on healthcare services, finance, regulatory interpretations, and problem-solving.

• Capability to research, analyze data, and provide sound recommendations.

• Excellent verbal and written communication skills are essential.

• Advanced skills in using Microsoft Suite applications.

• High attention to detail is crucial.

• A commitment to support IEHP’s initiative to become a 5-Star Health Plan and to integrate LEAN principles into daily activities.

🏝️ Benefits

• Competitive salary.

• On-site state-of-the-art fitness center.

• Medical insurance that includes dental and vision coverage.

• Options for life, short-term, and long-term disability insurance.

• Opportunities for career advancement and professional growth.

• Wellness programs that foster a healthy work-life balance.

• Flexible Spending Account for Health Care and Childcare.

• CalPERS retirement plan.

• 457(b) plan option with a contribution match.

• Paid life insurance for employees.

• Pet care insurance available.