- Utilize health care applications, data systems, data warehouses and data integration to pull and analyze data.
- Review and perform QA validation of data outputs and provide feedback to stakeholders, including root cause analysis, if any; document test cases and results.
- Process improvement and documentation for quality projects; create process flow diagrams; oversee implemented changes; write test plans based off technical requirements.
- Work with the IT team to create a formal quality assurance process for new HEDIS files.
- Provide project and task management for quality projects including facilitating stakeholder and project team meetings, tracking actionable items, sending regular project communications to internal and external stakeholders, and escalating identified risks.
- Engage with Quality and IT teams to review and understand related business data issues and determine ongoing efficiencies.
- Support Health Services teams for quality analysis and improvement.
- Audit data accuracy and reporting and provide performance deviations and anomalies.
- Perform other related duties as required or assigned.
- Bachelor's Degree in Healthcare, Information Systems, or related field, or equivalent experience, training or coursework. (R)
- Minimum two years of experience as a business analyst analyzing data for the purpose of informing business decisions. (R)
- Minimum one year of experience with healthcare management information systems. (R)
- Ability to write test plans based off technical requirements. (R)
- Ability to identify, troubleshoot, and resolve small to medium scale, basic to moderate business and systems issues. (R)
- Ability to organize work and present results in a professional manner. (R)
- Working knowledge of and the ability to efficiently operate all applicable computer software including computer applications such as Outlook, Word and Excel. (R)
- Ability to use a keyboard with moderate speed and a high level of accuracy. (R)
- Excellent communication skills including the ability to express oneself clearly and concisely when providing service to SCFHP internal departments, providers and outside entities over the telephone, in person or in writing. (R)
- Ability to think and work effectively under pressure and accurately prioritize and complete tasks within established timeframes. (R)
- Ability to assume responsibility and exercise good judgment when making decisions within the scope of the position. (R)
- Ability to maintain confidentiality. (R)
- Ability to comply with SCFHP's policies and procedures. (R)
- Ability to perform the job safely with respect to others, to property, and to individual safety. (R)
- Mobility Requirements: regular bending at the waist, and reaching overhead, above the shoulders and horizontally, to retrieve and store files and supplies and sit or stand for extended periods of time; (R)
- Lifting Requirements: regularly lift and carry files, notebooks, and office supplies that may weigh up to 5 pounds; (R)
- Visual Requirements: ability to read information in printed materials and on a computer screen; perform close-up work; clarity of vision is required at 20 inches or less; (R)
- Dexterity Requirements: regular use of hands, wrists, and finger movements; ability to perform repetitive motion (keyboard); writing (note-taking); ability to operate a computer keyboard and other office equipment (R)
- Hearing/Talking Requirements: ability to hear normal speech, hear and talk to exchange information in person and on telephone; (R)
- Reasoning Requirements: ability to think and work effectively under pressure; ability to effectively serve customers; decision making, maintain a concentrated level of attention to information communicated in person and by telephone throughout a typical workday; attention to detail. (R)
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Quality Improvement Analyst - San Jose, United States - Santa Clara Family Health Plan
Description
Quality Improvement Analyst
Salary Range: $92,492 - $138,738
The expected pay range is based on many factors, such as experience, education, and the market. The range is subject to change.
FLSA Status: Exempt
Department: Quality Improvement
Reports To: Manager, Quality Improvement
Employee Unit: Employees in this classification are represented by Service Employees International Union (SEIU) Local No. 521.
GENERAL DESCRIPTION OF POSITION
The Quality Improvement Analyst facilitates ongoing measurement, data optimization, reporting and information dissemination with a focus on data integrity, integration, standardization, analysis, and visualization. This role collaborates with multi-disciplinary teams and assists in the development of data management and analysis plans, monitors reporting requirements, establishes guiding metrics and benchmarks for performance improvement initiatives in support of the maintenance and improvement of SCFHP Quality programs and plan objectives. The Quality Improvement Analyst acts as a liaison between the Quality Department, Finance Department and IT by reviewing business requirements, functional specifications and internal operations processes.
ESSENTIAL DUTIES AND RESPONSIBILITIES
To perform this job successfully, an individual must be able to satisfactorily perform each essential duty listed below.
REQUIREMENTS - Required (R) Desired (D)
The requirements listed below are representative of the knowledge, skill, and/or ability required or desired.
WORKING CONDITIONS
Generally, duties are primarily performed in an office environment while sitting or standing at a desk. Incumbents are subject to frequent contact with and interruptions by co-workers, supervisors, and plan members or providers in person, by telephone, and by work-related electronic communications.
PHYSICAL REQUIREMENTS
Incumbents must be able to perform the essential functions of this job, with or without reasonable accommodation:
ENVIRONMENTAL CONDITIONS
General office conditions. May be exposed to moderate noise levels.
EOE
