Quality Measurement Analyst - Impresiv Health : Job Details

Title: Quality Measurement Analyst

Duration: 1/06/2025-3/17/2025

Schedule: Remote, Monday-Friday 8a-5pm PST

**Please no third party candidates at this time**

Description:

The Quality Department is committed to preventing disease, ensuring patient safety, and eliminating inequities by improving the quality of care received by members through partnerships with providers and community-based organizations.

This position is responsible for providing analytical support to the Quality Department's strategic objectives and to support:

• Ongoing clinical measurement and improvement processes, such as year-round Gaps in Care reporting
• Surveillance of innovative quality improvement interventions
• Functioning as a primary systems configuration analyst, programmer/analyst, and technical liaison to IT Department programmers that support QM initiatives.

What You Will Do:

• Provide dedicated analytical support within the Quality Department, including but not limited to, the design and creation of SQL data extract queries to identify healthcare disparities and monitor effectiveness of interventions to maximize quality of care and delivery of service
• Support the design, configuration, and maintenance of quality measurement tools including population health management dashboards to ensure effective oversight of the Quality Improvement and Health Equity Transformation Program, Quality Improvement System, and pay-for-performance programs
• Configuration and thorough validation of data files necessary to execute HEDIS, Gaps in Care, and pay-for-performance program reporting
• Assist in the development and implementation of solutions to meet ongoing strategic objectives
• Support vendor software system updates as needed in collaboration with Sr. Quality Measurement Specialist to ensure to routine quality measurement of required quality of care indicators
• Assist Population Health and Clinical Quality teams with measurement of quality improvement priorities (e.g., Performance Improvement Projects) and population health initiatives and advance health equity
• Development, editing and analysis of reports through Cognos
• Collection of primary source data to conduct data validation to assure the accuracy and reliability HEDIS, Gaps in Care, and Pay for Performance program reporting
• Participate in audits, audit readiness preparation, and related activities
• Serve on various staff committees, teams and workgroups as appropriate
• Other duties as assigned.

You Will Be Successful If:

• Strong team-oriented ability to connect with department staff, and establish and maintain positive professional working relationships within and outside health plan
• Proficiency in SQL programming and in complex analysis using Microsoft Excel
• Ability to evaluate data, identify trends, variances, relational dependencies, establish facts and draw valid conclusions, and inform the strategic direction of improvement initiatives
• Familiarity with medical records, including collection of data from various EMR systems
• Ability to perform claims research, conduct data validation and other data reporting activities as needed
• Ability to perform effectively under pressure and maintain focus on daily responsibilities for long-term projects
• Ability to establish and nurture positive professional working relationships with customers
• Ability to contribute to building a strong team dynamic
• Effective oral and written communication and presentation skills
• Understanding how to measure and monitor key performance indicators associated with managed care operations.
• Ability to perform HEDIS medical record abstraction in circumstances when collaboration will relieve department workload and achieve strategic objectives

What You Will Bring:

• Bachelor's Degree in a job-related field
• 3 years' experience in a health plan setting, or a combination of academic, professional or work experience that demonstrates ability to perform duties of position
• SQL programming proficiency
• Familiarity with business intelligence systems, e.g., Cognos
• Significant analytical skills and experience analyzing utilization data
• Knowledge of NCQA HEDIS technical specifications preferred
• Knowledge of NCQA Accreditation standards preferred
• An emphasis in Medicare or Medicaid/Medi-Cal managed care preferred
• Professional certification in a technical discipline (SQL, Cognos, etc.) preferred
• Knowledge of Medi-Cal, Medicaid or medical claims processing and clinical quality measurement preferred

About Impresiv Health:

Impresiv Health is a healthcare consulting partner specializing in clinical & operations management, enterprise project management, professional services, and software consulting services. We help our clients increase operational efficiency by delivering innovative solutions to solve their most complex business challenges.

Our approach is and has always been simple. First, think and act like the customers who need us, and most importantly, deliver what larger organizations cannot do – provide tangible results that add immediate value, at a rate that cannot be beaten. Your success matters, and we know it.

That's Impresiv!