HEDIS Quality Analyst III at CareSource

, Massachusetts, United States -

Full Time

Start Date

Immediate

Expiry Date

04 Sep, 26

Salary

115500.0

Posted On

06 Jun, 26

Experience

2 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

SQL, SAS, DAX, Power BI, Alteryx, HEDIS, Data Analysis, Data Visualization, Trend Analysis, Microsoft Office Suite, Managed Care Organization Knowledge, Complex Problem Solving, Critical Thinking, Technical Writing, Stakeholder Management, Data Architecture

Industry

Insurance

Description

Job Summary: The Quality Analyst III is responsible for analyzing and interpreting complex healthcare data. This role will collaborate with cross-functional teams, providing analytical insight to inform strategy and interventions to drive improved quality performance Essential Functions: Generate comprehensive reports, graphics and dashboards that effectively summarize and display data for key stakeholders Review reports and data for pattern identification, special cause variation identification, trend analysis, or other techniques and provide management level summaries that explain key findings Provide technical expertise and guidance to team members on SQL, SAS, and DAX coding best practices, visualizations, and table locations Interpret and maintain understanding of technical specification and other quality reporting requirements and ensure any changes are implemented and communicated with key stakeholders timely Interact and work collaboratively with business partners on analysis, reports and data patterns to identify trends Gather, understand and refine requirements for analytics requests including but not limited to HEDIS, Population Health, Pharmacy Quality, Accreditation, Health Equity, business development and RFP requests Collaborate with IT teams to enhance data collection and reporting systems Perform any other job duties as assigned Education and Experience: Bachelor of Science/Arts degree in Management Information Systems (MIS), computer science or related field or equivalent work experience is required Master of public health (MPH), Business Administration (MBA), mathematics, statistics, or related field is preferred Minimum of three (3) years of experience in data analysis and/or analytic programming is required Minimum of three (3) years of HEDIS or similar healthcare quality performance metrics experience is required 3-5 years Programming experience (i.e., SQL, SAS, Alteryx ) is required Programming in DAX/Power BI is preferred Health care delivery, clinical experience and/or payer experience is preferred. Competencies, Knowledge, and Skills: Intermediate proficiency level with Microsoft Office Suite Complex problem-solving skills for solving multi-dimensional business questions Proficient in Programming language (i.e., two of SQL, SAS and/or DAX) is required Managed Care Organization knowledge and familiarity Graphic development & presentation skills Exposure to statistical concepts strongly preferred Critical thinking and active listening skills Effective verbal and written communication skills Ability to lead analytic efforts Ability to serve as liaison with business partners Knowledge of managed care and health care data coding Ability to interface with IT teams, familiarity with MDS and advanced data architecture Licensure and Certification: None Working Conditions: General office environment; may be required to sit or stand for extended periods of time Compensation Range: $72,200.00 - $115,500.00 CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package. Compensation Type (hourly/salary): Salary Organization Level Competencies Fostering a Collaborative Workplace Culture Cultivate Partnerships Develop Self and Others Drive Execution Influence Others Pursue Personal Excellence Understand the Business This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an environment of belonging that welcomes and supports individuals of all backgrounds. #LI-JM1 The CareSource mission is known as our heartbeat. Just as we support our members to be the best version of themselves, our employees are driven by our mission to create a better world for members, stakeholders and providers. We are difference-makers who combine compassionate hearts with our unique business expertise to make every opportunity count. Each claim, each phone call, each consumer-centric decision is a chance to change the world for one member, and our employees look for ways to do that every day. The challenge is, there is no one right way to be the difference and we’re looking for people like you that will rewrite that definition every day. We do what it takes to form creative solutions that make our community and the world just a little better. Discover what it means to be #UniquelyCareSource.

Responsibilities

The Quality Analyst III analyzes complex healthcare data to generate reports, dashboards, and insights that drive quality performance. They collaborate with cross-functional teams and IT to refine analytics requests and enhance data collection systems.