Manager, Quality Data & Analytics

US-CA-Irvine
Req No.
2017-2091
Category
Finance & Accounting
Type
Regular Full-Time

Overview

ConcertoHealth delivers comprehensive care to Medicare, Medicaid, and complex-needs patients. For over a decade, we have provided extraordinary outcomes for thousands of people in these underserved groups.
The ConcertoHealth name reflects our unique approach to healthcare. It’s about how we work in concert with patients, providers, and health plans. It’s about the harmony of a patient’s care, health, and dignity.
 
The Manager, Quality Data & Analytics will lead the production and analysis of quality measures by being the technical Subject Matter Expert (SME) associated with Quality Data and Ratings. This candidate will bring extensive expertise of the HEDIS, CAHPS, HOS, and STARS measures and will integrate that knowledge with ConcertoHealth’s quality-based business processes, IT programs and capabilities, and quality initiatives to ensure the achievement of the maximum quality ratings possible for ConcertoHealth and our partner related organizations. As the Quality SME, the candidate will bring expertise related to technical specifications associated with the various quality programs and initiatives as well as the capability to utilize this knowledge to develop and successfully execute quality related operational processes.

Responsibilities

  • Provides technical subject matter expertise related to quality program (HEDIS, CAHPS, HOS, STARS, etc.) measures
  • Coordinates the analysis of quality related measures and statistics and facilitates the reporting of results to ConcertoHealth leadership and external partner management
  • Maintains knowledge of changing quality program measures and requirements and works with IT and other staff to ensure all systems and reporting capabilities are properly updated and maintained
  • Serves as Quality SME and technical resource for IT team in the development/modification of a Quality Engine and Dashboard for use in calculating, monitoring, and reporting the status of quality measures on an on-going basis
  • Leads the execution of quality related initiatives and activities, in conjunction with partner organizations
  • Completes other quality related tasks and projects as assigned

Qualifications

  • Undergraduate degree or equivalent experience
  • 3+ years of progressive experience in the areas of Quality and Quality reporting including HEDIS, CAHPS, HOS, and STARS
  • Advanced experience with data sources and methods associated with Quality reporting
  • 5+ years of healthcare industry experience, preferably in the managed care industry
  • Knowledge of the Medicare, Medicaid, and Medicare Advantage healthcare plans
  • Advanced proficiency with MS Excel, Word, and PowerPoint
  • Strong written and verbal communication skills
  • Demonstrated ability to communicate ideas clearly and concisely
  • Excellent time management, organizational, and prioritization skills and ability to balance multiple priorities

Preferred Qualifications:

  • Understanding of Health Plan, Provider Group, and Clinic Operations
  • Experience working in Healthcare Settings/with Clinicians
  • Experience working with IT and database technologies

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