Coordinates complex assignments involving cross functional teams in the fullfillment of contract deliverables, regulatory and accreditation requirements with focus on data analytics and performance improvement. Models and promotes the core values of WellCare. Provides data analytics assistance to all levels within Quality Improvement departments at either a market, division or corporate level.
REPORTS TO: Sr. Mgr, Quality Improvement
Additional Responsibilities: Candidate Education:
- Defines analysis methodology and provides analytic support to QI staff.
- Maintains databases and reports specific to QI functions and regulatory and accreditation requirements.
- Collaborates with other teammates to deliver solid, effective solutions.
- Provides data for select performance measures to market offices.
- 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.
- Recommends enhancements to existing systems in accordance to business needs by creating ad hoc and standard reports as well as new information delivery technologies.
- Acts as point of contact for business users providing both tool support and data expertise.
- Develops and provides insights into streamlining analytic QI processes.
- Prepares reports and quality improvement studies in an accurate, consise and timely fashion.
- Coordinates centralized and market work plans and actions 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.
- Assists in the HEDIS data collection process, analyzing trends, and identifying areas of improvement.
- Performs other duties as assigned.
- Required A Bachelor's Degree in Public Health, Epidemiology, Information Management or other related health field
- Preferred A Master's Degree in a related field
- Required 5 years of experience in data analytics via collecting, analyzing, and presenting data and recommendations to management
- Required Other Knowledge of quality improvement philosophy and techniques
Licenses and Certifications:
- Intermediate Demonstrated written communication skills
- Intermediate Ability to analyze information and covert related activities into a comprehensive work plan
- Intermediate Ability to work within tight timeframes and meet strict deadlines
- Intermediate Ability to work in a fast paced environment with changing priorities
- Intermediate Demonstrated analytical skills
- Intermediate Demonstrated organizational skills
- Intermediate Demonstrated problem solving skills
- Intermediate Demonstrated interpersonal/verbal communication skills
- Intermediate Ability to identify basic problems and procedural irregularities, collect data, establish facts, and draw valid conclusions
- Intermediate Ability to multi-task
- Intermediate Other Ability to utilize other data management systems to pull and analyze information to draw conclusions and recommendations.
A license in one of the following is required:
- Preferred Certified Professional in Healthcare Quality (CPHQ) Certified Professional in HealthCare Quality
- Required Advanced Microsoft Excel
- Required Intermediate Microsoft Word
- Required Intermediate Microsoft PowerPoint
- Required Intermediate Microsoft Outlook
- Preferred Beginner Statistical Analysis Systems (SAS)
- Required Beginner Microsoft Access
- Required Intermediate Other Ability to utilize other data management systems to pull and analyze information to draw conclusions and recommendations.