Note: The job is a remote job and is open to candidates in USA. EmblemHealth is seeking a Senior Analyst to support its quality department’s digital HEDIS strategy through analytics, reporting, and predictive modeling. The role focuses on automating reporting and data governance, developing quality dashboards and models, coordinating digital readiness, and presenting insights to stakeholders to support quality improvement and strategic decision-making.
Responsibilities
- Implement reporting and reconciliation workflows and document processes
- Responsible for medical trend studies as they pertain to quality initiatives
- Identify data improvement opportunities through review of HEDIS/QARR/Star reports and data outputs and detecting data acquisition, capture, and system error issues
- Work with IT and others to plan and execute digital readiness, including readiness for FHIR
- Work with vendors, providers, and others to identify new sources of clinical data ingestion (e.g. data aggregators, EHRs, HIEs, etc)
- Perform research and collection of data, including data mining and reporting, which is provided to various customers inside and outside the department
- Develop complex and/or advanced statistical/modeling analyses of quality metrics for Medicare, State Sponsored Programs, and other populations
- Maintain automated quality dashboards and measure profiles utilizing data visualization tools
- Provide analytical and technical support for design, development and maintenance of quality improvement and wellness initiatives. Build self-service reports to be used by the quality department
- Analyze business problems related to quality experience of member, particularly related to how members receive care and other factors influencing the STARS rating
- Present analytical findings to internal business partners, leading discussions and providing delivery of further analysis
- Collaborate with internal quality management teams to assist on quality improvement initiatives
Skills
- • Bachelor's Degree in analytical/quantitative field including healthcare management, finance, business, mathematics, engineering, applied stats/economics, or any other related fields
- • 4 – 6+ years of relevant, professional work experience (Required)
- • 3+ years of experience in managed care/healthcare analytics (Required)
- • Advanced knowledge of HEDIS and Medicare Stars, including experience working with electronic clinical quality measures and related data sources (Required)
- • Proficient in Microsoft Office (Word, PowerPoint, Excel, Access) (Required)
- • Advanced experience with relational database applications (such as SAS, R, SQL, or others) (Required)
- • Experience with improving and automating processes using programming languages/software (Python, VBA, R, SAS, C++, or others) (Required)
- • Experience with and proficient in data visualization tools (such as Power BI, Tableau) (Required)
- • Strong communication skills (verbal, written, presentation, interpersonal) (Required)
- • Demonstrated self-starter with ability to develop projects end to end independently (Required)
- • Master's Degree preferred
- • Experience with and proficient in statistical software/programs (such as SAS, R, Stata, Minitab or others) (Preferred)
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