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Quality Data Analyst

Quality Data Analyst

PacificSourcePortland, OR, US
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Quality Program Analyst

Looking for a way to make an impact and help people? Join PacificSource and help our members access quality, affordable care! PacificSource values the diversity of our community and is committed to creating and fostering a work environment in which individual differences and diversity are appreciated, respected, and responded to in ways that fully develop and utilize each persons talents and strengths.

Responsible for supporting the execution of the assigned quality program strategy through data analysis to drive results to improve or maintain quality performance, outcomes, and / or rating. This position will be responsible for the development of reports, enhancements to existing reports, data analysis, and business processes which will inform and enable leader(s) to make informed decisions based on data. This position involves collaborating with cross-functional teams, ensuring the accuracy and completeness of Quality data, to optimize processes to enhance performance, maximize revenue, and ensure compliance.

Essential Responsibilities :

  • Collect, analyze, and interpret quality performance and results using statistical techniques.
  • Generate regular reports on performance metrics, trends, and areas for improvement.
  • Develop and maintain dashboards to track key performance indicators (KPI).
  • Execute quantitative analyses that translate data into actionable insights.
  • Review reports and performance indicators to improve quality ratings.
  • Provide analytical and data-driven, decision-making support for key projects.
  • Identify opportunities for improvement in quality ratings and measures.
  • Collaborate with cross-functional teams to develop and implement action plans.
  • Monitor the effectiveness of interventions and adjust strategies as needed.
  • Communicate findings on a regular basis to all levels of business and management.
  • Stay apprised of changes made by regulatory and governing bodies to relevant program guidelines, methodology, and regulations.
  • Interpret policy changes and model impacts to plan performance and operations.
  • Work closely with internal departments, including clinical, operations, and customer service teams, to align quality improvement efforts.
  • Communicate findings and recommendations to senior management and other stakeholders.
  • Provide training and support to staff on quality program requirements and best practices.
  • Support strategist to improve member and provider engagement, increase compliance, and drive gap closures.
  • Share insights with stakeholders to support the production of educational materials and campaigns.
  • Stay current with industry trends, best practices, and regulatory changes related to the applicable quality ratings program.

Supporting Responsibilities :

  • Support quality improvement activities, designated committees, and / or task forces to ensure delivery of quality, cost-efficient, high-quality member care.
  • Meet department and company performance and attendance expectations.
  • Follow the PacificSource privacy policy and HIPAA laws and regulations concerning confidentiality and security of protected health information.
  • Perform other duties as assigned.

    • Success Profile :

    Work Experience : Minimum of 3 years of experience in data analysis or a related field required. Experience with health plan quality improvement, specifically quality metrics, or other healthcare quality related experience preferred.

    Education, Certificates, Licenses : Bachelor's degree in healthcare administration, business administration, mathematics, computer science, information systems, or related field, or equivalent years of additional relevant experience in lieu of degree is required. Master's degree is preferred.

    Knowledge : Proven proficiency in data analysis tools and software (e.g., Excel, SAS, SQL) and data visualization / analytics tools (Tableau, Power BI) required. Knowledge of CMS Stars rating and OHA Quality Incentive measures including HEDIS, CAHPS, PQA / Pharmacy, HOS, and Display measures. Demonstrated skills in quality improvement concepts, healthcare data analysis, data mining methods, and the identification of population health issues, trends, and health disparities using healthcare data sources. Demonstrated ability to analyze complex data sets, identify patterns, and drive actionable insights. Familiarity with statistical analysis and machine learning techniques is a plus. Exceptional problem-solving and critical-thinking abilities, with strong attention to detail. Ability to identify and resolve technical issues in a timely manner. Must have strong business acumen to interpret strategic vision into an operational model. Ability to work independently with minimal supervision.

    Competencies :

  • Adaptability
  • Building Customer Loyalty
  • Building Strategic Work Relationships
  • Building Trust
  • Continuous Improvement
  • Contributing to Team Success
  • Planning and Organizing
  • Work Standards

    • Environment :

    Work inside in a general office setting with ergonomically configured equipment. Travel is required approximately 10% of the time.

    Skills :

  • Accountability
  • Collaboration
  • Communication (written / verbal)
  • Flexibility
  • Listening (active)
  • Organizational skills / Planning and Organization
  • Problem Solving
  • Teamwork

    • Our Values :

  • We are committed to doing the right thing.
  • We are one team working toward a common goal.
  • We are each responsible for customer service.
  • We practice open communication at all levels of the company to foster individual, team, and company growth.
  • We actively participate in efforts to improve our communities-internally and externally.
  • We actively work to advance social justice, equity, diversity, and inclusion in our workplace, the healthcare system, and community.
  • We encourage creativity, innovation, and the pursuit of excellence.

    • Physical Requirements :

    Stoop and bend. Sit and / or stand for extended periods of time while performing core job functions. Repetitive motions to include typing, sorting, and filing. Light lifting and carrying of files and business materials. Ability to read and comprehend both written and spoken English. Communicate clearly and effectively.

    Disclaimer : This job description indicates the general nature and level of work performed by employees within this position and is subject to change. It is not designed to contain or be interpreted as a comprehensive list of all duties, responsibilities, and qualifications required of employees assigned to this position. Employment remains AT-WILL at all times.

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