Quality Metrics Analytics Manager - SHCN
Position Purpose: Ensure timely availability of accurate performance metrics, presented in a format understandable to various audiences
Leads the creation and maintenance of meaningful analytics, visualization, reports, and presentations most appropriate to users based on their role that enable insights to actionable next steps. Oversees ad-hoc reports and analytic support, using project management tools to gather user requirements and confirm user acceptance. Leads automation of business processes, such as on-demand reports and interactive dashboards; identifies and implements opportunities to streamline and improve processes. Maintains a Stars predictive model and reports Stars data to CMS; maintains associated written procedures.
Implements ongoing processes to QA performance data and vendor reports/data; addresses gaps or inaccuracies with vendor; maintains associated written procedures. Maintains a QA procedure to ensure information reported is highly accurate.
Monitors changes in regulatory contractual requirements related to performance measures, initiates change requests with data vendor, identifies organizational impacts and implements necessary organizational and reporting changes.
Builds a first-in-class quality analytics program using creative, innovative strategies and best practices. Builds infrastructure and lean processes to ensure sustainability and advance the department. Provide training, orientation, performance appraisals, hiring and disciplinary action of the analytical staff. Ensures team develops new data competencies. Represents team at meetings with peers, executives, vendors and other stakeholders; presents at meetings as needed. Provide oversight and leadership in developing statistical analyses to support the Quality Department. Present analyses to stakeholders in both internal and external meetings. Provide insight, advise quality improvement teams, and respond to regulators’ requests on quality metrics through presentations, detailed narratives, etc.
Education: Bachelor’s degree or equivalent obtained at a four-year college or university in Computer Science, Informatics, Epidemiology, Health Administration, related field, or equivalent professional experience.
Years of Experience: Minimum of 4 years related experience. Experience working with HEDIS, CMS or other related metrics is strongly preferred.
· Advanced Excel and VBA skills
· Ability to learn new applications
· Advanced understanding of identifying sources of, collecting, and analyzing data and metrics using statistical methods, technical processes and SQL
· Proficiency in project management
· Ability to think analytically to resolve issues; solution-focused mindset; creative and innovative
· Ability to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames