Community Care Plan

Quality Improvement Analyst

Position Summary:


The Quality Improvement Analyst implements and supports quality initiatives across the organization. This role provides subject matter expertise related to quality initiative implementation, reporting and analysis. The Quality Improvement Analyst supports ongoing workflow enhancements for various projects and enhance the organization’s overall efficiencies related to quality improvement.

Essential Duties and Responsibilities:


  1. Responsible for completing analysis to understand the population and help the organization develop strategies to close care gaps and maximize performance on quality measures .
  2. Ability to analyze and interpret healthcare data using tools like Excel, SQL, or Power BI.
  3. Assists with generation of State-specific performance measurement requirements.
  4. Collaborates with other department staff to convert data sources for use in performance measure reporting as needed.
  5. Evaluates quality improvement data for quality initiatives comply with regulatory requirements and / or accreditation standards.
  6. Participates in NCQA accreditation and regulatory audit preparedness.
  7. Analysis of Medical Record and Quality Metric Data.

This job description in no way states or implies that these are the only duties performed by the employee occupying this position. Employees will be required to perform any other job-related duties assigned by their supervisor or management.


Skills and Abilities:


  • Strong interpersonal, organizational and communication skills
  • Detail oriented, ability to multitask, and timeline driven
  • Quantitative skills and ability to perform data analysis and problem solving
  • Ability to manipulate data and create strong visual presentation
  • Result and solution oriented to address obstacles and provide solutions
  • Ability to prepare and present concepts and proposals to all levels of management

Work Schedule:

As a continued effort to provide a safe and productive work environment, Community Care Plan is currently following a hybrid work schedule. Staff are able to work from home 3 days a week and will report to the office 2 days a week. *****The company reserves the right to change the work schedules based on the company needs.


Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to sit, use hands, reach with hands and arms, and talk or hear. The employee is frequently required to stand, walk, and sit. The employee may occasionally be required to stoop, kneel, crouch or crawl. The employee may occasionally lift and/or move up to 15 pounds.


Work Environment:

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of the job. The environment includes work inside/outside the office, travel to other offices, as well as domestic travel. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.

We are an equal opportunity employer who recruits, employs, trains, compensates and promotes regardless of age, color, disability, ethnicity, family or marital status, gender identity or expression, language, national origin, physical and mental ability, political affiliation, race, religion, sexual orientation, socio-economic status, veteran status, and other characteristics that make our employees unique. We are committed to fostering, cultivating, and preserving a culture of diversity, equity, and inclusion.


Qualifications

  • Bachelor’s degree in a relevant field (e.g., healthcare administration, public health, nursing).
  • 3-5 years of experience in healthcare quality analysis or a related role.
  • Knowledge of HEDIS, State/NCQA/CMS quality measure requirements.
  • Experience in Healthcare/Managed Care Organization (MCO).
  • Intermediate analytics skills.
  • Strong Knowledge of Excel, PowerPoint, SQL, and Power BI (preferred)
  • Ability to work independently and collaborate effectively in a team environment.

  • Seniority level

    Mid-Senior level
  • Employment type

    Full-time
  • Job function

    Quality Assurance
  • Industries

    Insurance

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