Performance Quality Analyst

United States Minor Outlying Islands, Armed Forces Americas

Remote position available

Job Description

The Performance Quality Analyst is responsible for driving service quality excellence by evaluating the quality of services and interactions provided by Magellan Complete Care business units. Included are processes related to data structuring and management for Quality related activities. This position coordinates complex assignments involving cross functional teams in the fulfilment of contract deliverables, regulatory and accreditation requirements with focus on data analytics and performance improvement. The Performance Quality Analyst provides data analytics assistance to all levels within Quality Improvement at both a market and corporate level and develops documents and programs in support of HEDIS, STARS, performance measures and other tracking as needed per state, federal, compliance and accreditation requirements.

  • Maintains databases and reports specific to QI functions and regulatory and accreditation requirements for HEDIS, STARS, state specific programs 
  • Collaborates with other teammates to deliver robust, effective solutions 
  • Provides data for select performance measures to state leads 
  • Communicates with external data sources as needed to gather data necessary to measure identified outcomes 
  • Prepares ad hoc reports as needed for QI management 
  • Identifies, evaluates and implements new data-driven strategies and processes for the organization 
  • Develops tools and reports that lend valuable insights that capitalize on a combination of internal and external data for HEDIS, STARS, state, federal and accreditation requirements and performance measures; develops and provides insights into streamlining analytic QI processes. 
  • Recommends enhancements to existing systems in accordance to business needs by creating ad hoc and standard reports as well as new information delivery technologies 
  • Utilizes software programs such as SAS, SQL, Excel, heat mapping and/or other business intelligence tools to extract needed data 
  • Interprets data accurately and produces clear and comprehensive written analyses, graphics, tables, etc. for diverse internal and external audiences 
  • Plans, organizes, and prioritizes assigned projects, creating and managing work plans that reflect the tasks, time frames, and processes required to successfully complete each 
  • Assists in the HEDIS data collection process, analyzing trends, and identifying areas of improvement 
  • Prepares reports and quality improvement studies in an accurate, concise, and timely manner 
  • Coordinates centralized and state action plans with team members assuring project timeliness and expectations are met 
  • Manages key project initiatives associated with delegated vendor functions, monitoring and summarizing vendor oversight project progress 
  • Participates in cross functional internal and external quality teams to improve overall organization performance 
  • Performs data collection, analysis, reporting and presentation of quality improvement activities 
  • Ensures understanding of customer needs by proactively clarifying scope and requirements and keeping customers apprised of project status through effective communication 
  • Supports customer understanding of analytical findings through effective presentation of results to individuals and groups 
  • Manages multiple projects by effectively prioritizing work and communicating workload issues to management 
  • Contributes to team effort by accomplishing related results as needed 
  • Prepares ad-hoc analyses and work on special projects 
  • Extensive expertise in hybrid strategy, coding and chase logic 
  • Performs other duties as assigned 

General Job Information

Title

Performance Quality Analyst

Grade

24

Job Family

Quality Group

Country

United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date

1/20/2020

Date Requisition Created

1/19/2020

Work Experience

Analytics/Informatics

Education

Bachelors: Computer and Information Science (Required), Bachelors: Mathematics (Required), Bachelors: Statistics (Required), Masters: Computer and Information Science, Masters: Mathematics, Masters: Statistics

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements

Responsibilities

Required Qualifications

  • Bachelor’s or above degree in Math, Statistics, Biostatistics, Computer Science, or other quantitative disciplines
  • 5+ years of experience in data analytics
  • Strong analytical skills
  • Ability to effectively interact with, and present findings to customers at various levels of the organization 
  • Advanced SAS knowledge 
  • Ability to document processes and analyses for reference/re-use
  • Excellent technical, interpersonal, written and oral communication skills
  • Proficiency with MS SQL (queries) and Tableau
  • Clinical code knowledge related to claims/utilization
  • Proficient in MS Office with advanced knowledge of MS Access, to create ad-hoc reports, forms and design databases 

Preferred Qualifications

  • Master’s degree in Math, Statistics, Biostatistics, Computer Science, or other quantitative disciplines
  • Demonstrated experience in leading significant cross-functional work 
  • Experience with managed care contract terms/analysis
  • Excellent knowledge of HEDIS, NCQA, Medicare Stars and Medicaid 
  • Experience in a Medicare Advantage and Medicaid environment

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.

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