Analyst, Quality/Risk Adjustment
Steward Health Care Network (SHCN) takes pride in its community-based care model, which drives value-added tools and services to our communities, patients, physicians, and hospitals across the continuum of care. In addition, Steward Health Care Network promotes care coordination and collaboration within the network in order to provide high-quality, efficient care to patients. With Steward in the community, all residents can be sure that there is a world class doctor close to where they live.
The network is also responsible for the implementation and execution of our managed care contracts, medical management services, quality improvement programs, data analysis, and information services.
Reporting to the Director of Analytics, the Analyst, Quality/Risk Adjustment will work in tandem with the Analytics team and The Performance Operations Quality team to provide expertise and insights into quality performance that will inform quality improvement strategy and Steward Health Care Network (SHCN) resource investment to improve quality performance.
- Responsible for maintenance, support and HEDIS coding required to report performance rates to target for appropriate quality measures across all Steward Commercial, Medicare and Medicaid risk contracts
- Collaborate with the Performance Ops Quality team to provide analytics support of measure performance within SHCN value-based contracts that range from NCQA HEDIS measures to CMS ACO to patient experience of care survey data to risk contract custom measures.
- Update and maintain quality dashboards required for monthly close meetings, to support annual HEDIS project plans for multiple LOBs
- Ensure maximum level of data accuracy, integrity, consistency, and completeness in the various internal and external data sources used for end-user reporting purposes. Datasources include EMR, survey data and claims/enrollment data from vendor managed analytics datamart
- Develops and implements data-driven solutions to meet quality business requirements including population health management and member propensity to close gaps by producing analytics, reports, and data sets.
- Other duties as required based on business needs
Education / Experience / Other Requirements
- Bachelor's degree required; Master’s degree preferred
Years of Experience:
- Three (3) or more years of experience required, in health care quality data analysis in either a health plan setting or health system setting that included HEDIS claims coding and working with NCQA HEDIS measures.
- Strong SQL skills and use advanced functions of excel (VBA preferred)
- Intermediate to advanced level of BI visualization experience, preferably in tableau
- Strong analytic skills/ability to translate complicated data into useable information, including analysis of practice variation
- Strong leadership and management skills; self-directed
- Ability to generate creative solutions
Equal Opportunity Employer Minorities/Women/Veterans/Disabled