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011050 CCA-BI & Analytics

Position Summary:

The Advisor utilizes corporate databases, as well as data developed from surveys, chart reviews, clinical databases, and external sources to support core quality analytics reporting requirements and the implementation of other quality analytics reporting solutions. Primary responsibility is to assuring readiness for comprehensive report development to meet NCQA accreditation standards and report development on a recurring basis. The Advisor may also assist in the development and delivery of successful HEDIS submissions and reporting to meet other state and federal quality reporting requirements.

Supervision Exercised:

+ No supervision exercised.

Essential Duties & Responsibilities:

+ Under the supervision of the Manager, Quality Analytics, Measurement and Reporting, the Quality Analytics Analyst:

+ Assesses enterprise wide corporate NCQA reporting readiness

+ Maintains up-to-date knowledge and understanding of all Standards within the NCQA Health Plan accreditation survey set.

+ Responsible for consulting with clients on business and NCQA needs, translating needs into actionable intelligence and/or report development. Helps internal customers anticipate analytic needs to support strategic goals

+ Collaborates with key functional areas and leadership to ensure any gaps in processes or data are closed speedily and comprehensively

+ Ensures a continuous state of report readiness for ongoing accreditation surveys

+ Partners with relevant software vendors to close gaps embedded in internal systems

+ Collaborate with other CCA departments, including but not limited to the Information Technology and Business Intelligence departments, to establish prioritization for execution of deliverables and quality analytics reporting solutions enhancements

+ Maintains a thorough knowledge of CCA’s databases to provide feedback to Business Intelligence (BI) and Information Technology (IT) to resolve data integration issues, and support Quality’s NCQA, and other, reporting requirements.

+ Supports other Quality Programs data needed as requested

+ Provides assistance for HEDIS implementation and reporting, as needed

Working Conditions:

+ Standard office conditions.

Required Education:

+ BA/BS in Health Analytics, Public Health, Health Care Administration, Health Economics, or a related field with strong emphasis in data analysis.

Required Experience:

+ A minimum of 3-5 years of relevant experience in reporting and analyzing quality improvement measures in a health plan.

+ Experience executing in a fast-paced environment with tight deadlines.

Required Knowledge, Skills & Abilities:

+ Intermediate to advanced knowledge of analytic programming languages and data visualization tools, including SAS, SQL, and Tableau.

+ Ability to develop, interpret and explain analytics needed by the business for decision making

+ Demonstrated ability to develop and produce complex reports and dashboards. Experience and expertise with designing and executing analyses to evaluate the effectiveness of interventions to improve quality

+ Strong ability to generate information that is easily understood and actionable by customers in alignment with clearly defined analytic/reporting requirements

+ Possess excellent communication skills and ability to effectively interact with all levels of management

+ Knowledge of health plan operations and data sources.

+ Ability to organize, plan and prioritize assignments within multiple projects.

+ Ability to work with minimal direction and flexibility when rapid or extensive changes are needed

Desired Knowledge, Skills & Abilities:

+ Knowledge of NCQA and CMS measurement requirements and quality rating systems, preferred.

Language(s):

English

EEO is The Law

Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled

Please note employment with CCA is contingent upon acceptable professional references, a background check (including Mass CORI, employment, education, criminal check, and driving record, (if applicable)), an OIG Report and verification of a valid MA/RN license (if applicable). Commonwealth Care Alliance is an equal opportunity employer. Applicants are considered for positions without regard to veteran status, uniformed service member status, race, color, religion, sex, national origin, age, physical or mental disability, genetic information or any other category protected by applicable federal, state or local laws.