QI Analyst at Partnership HealthPlan of California

Fairfield, California, United States -

Full Time

Start Date

Immediate

Expiry Date

14 Aug, 26

Salary

117113.58

Posted On

16 May, 26

Experience

0 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Data Analysis, Reporting, Statistics, Project Management, MS Excel, MS Access, Lean Methodology, Model for Improvement, HEDIS Reporting, Data Governance, Data Validation, Interpersonal Communication

Industry

Insurance

Description

Overview To prepare, analyze, report, and manage data used for both plan-wide and regional decision making for evaluating performance in key quality measures and the effective use of health plan resources on a routine and ad hoc basis. Works collaboratively with departments company-wide to identify data needs, develop and maintain data queries and tools, and complete accurate reporting to support performance and process improvements. Project/program involvement may include Partnership’s Healthcare Effectiveness Data Information Set (HEDIS) reporting initiative, Partnership Quality Dashboard (PDQ), Partnership’s provider pay-for-performance programs, and others as assigned. Responsibilities Develops and maintains working knowledge (technical and user interfaces) of Partnership data management and analytics programs and systems. May manage/monitor data integration into data infrastructure and may lead system-level user testing. Utilizes the Enterprise Data Warehouse and other data sources to identify and isolate data for analysis. Validates data reports and manages key data sources within program requirements, to ensure the completeness and accuracy of data. Works collaboratively with various departments (i.e. QI, IT, Finance, and Analytics teams) and external stakeholders to define business requirements and identify data needs. Refines reporting requests to support operational excellence initiatives and creates tools and reports to measure process/performance changes. Develops and executes data collection plans that identify baseline performance and capture the impact of interventions. Analyzes performance data (which may include data trending or stratification) to identify areas for improvement. Provides actionable recommendations and informs stakeholders of the impact of key decisions based on available data. Serves as active contributor in data quality or analytics workgroups. Develops and maintains standards and methodologies in data governance and data quality issue resolution timelines; streamlines reporting to reduce unnecessary duplication; ensures consistent and accurate use of data reporting; and provides accurate definitions of all data elements. Serves as a primary contact for internal and external stakeholders related to Partnership performance data management. Serves as the analytic lead on select operational initiatives as assigned. Maintains expert knowledge of assigned business unit. Provides project management support for data related and performance/process improvement projects, which may include HEDIS, PDQ, pay-for-performance programs, and others as assigned. Tracks multiple deliverables and collaborates closely with broader project team. Other duties as assigned. Qualifications Education and Experience Bachelor’s degree in related field; one – two (1-2) years of experience providing the knowledge and abilities listed. Special Skills, Licenses and Certifications Demonstrated aptitude for acquiring and applying technical skills in data analysis, reporting, and data systems. Good oral and written communication skills. Strong analytical skills including knowledge of statistics. Excellent interpersonal skills. Valid California driver’s license and proof of current automobile insurance compliant with Partnership policy are required to operate a vehicle and travel for company business. Performance Based Competencies Knowledge of MS Excel, Access, and other analytic software. Knowledge of Lean and Model for Improvement methodologies. Familiar with quality measurement and healthcare data. Ability to communicate technical concepts with both technical and non-technical individuals. Detail-oriented with good organizational and project management skills to work on multiple projects simultaneously within established time frames. Work Environment And Physical Demands Ability to use a PC with standard software packages. More than 70% of work time is spent in front of a computer monitor. When required, ability to move, carry, or list objects of varying size, weighing up to 25 lbs. All HealthPlan employees are expected to: Provide the highest possible level of service to clients; Promote teamwork and cooperative effort among employees; Maintain safe practices; and Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated. HIRING RANGE: $93,690.86 - $117,113.58 IMPORTANT DISCLAIMER NOTICE The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive or definitive of the tasks that an employee may be required to perform. The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.

Responsibilities

The role involves preparing and analyzing data to evaluate performance in key quality measures and health plan resource usage. The analyst collaborates across departments to develop data queries, tools, and reports to support operational excellence and process improvements.