Analytic Manager-Quality at Point32Health

Job Summary

The Analytic Manager will support HEDIS and quality analytics reporting and data analysis functions using SAS, SQL, and other software tools to produce and trend results for internal and external projects and constituents. The Analytic Manager provides technical support, data management, statistical analysis, and manipulation of data extracts to create reports for defined internal and external entities including NCQA, CMS and State regulatory reporting entities. The colleague in this role also conducts strategic measurement analyses to evaluate and detect opportunities for quality measure improvement.

Key Responsibilities/Duties – what you will be doing

• Provides technical and methodological design consultation, database development, software program development, data management, statistical analysis, and results interpretation/reporting for a variety of internal and external projects and constituents.
• Develops analytical frameworks, statistical models, and data visualizations by using SAS, SQL, Tableau, ACCESS, Cognos, and other database management tools for clinical data analyses.
• Evaluates HEDIS results and assesses opportunities for improvement activities including development of reporting and/or outreach for quality improvement initiatives. Supports internal quality initiatives with individualized data as needed.
• Responsible for evaluation of HEDIS data, including HEDIS rate investigations and root cause analyses in alignment with NCQA HEDIS specifications. Assumes all analytical responsibility on assigned projects to assess clinical quality for internal and external customers.
• Participates in annual updates to HEDIS and quality improvement processes through analysis, application development, user acceptance testing and debugging.
• Maintains a working knowledge of data structure and contents of all corporate data systems including: enterprise data warehouses, clinical information systems, automated medical records, encounter, hospital claims, outpatient claims, behavioral health claims, pharmacy, and enrollment data.
• Consults with appropriate Health Plan staff and managers to refine research questions, areas of opportunity, and suggested interventions. Make recommendations for business actions and future analysis.
• Participate in project teams and department meetings as required.

• Other projects and duties as assigned.

Qualifications – what you need to perform the job

Education

• Required (minimum): Master’s degree or BA/BS degree epidemiology, biostatistics, health policy/information management.

Experience

• Required (minimum): 7-10 years’ work experience in an analytic or data management environment, preferably in a health care or managed care setting. Thorough knowledge of health care terminology, processes, and operating environments as well as well-developed analytical abilities.

Skill Requirements

• Demonstrated proficiency in the use of spreadsheet applications, SAS, SQL, or others as required.
• Ability to research quality improvement best practices and adapt findings to current health plan systems, practices, and opportunities.
• Must be able to work independently, and in small work groups, with staff members and managers having similar or disparate interests and/or priorities.
• Demonstrated project planning, oral and written communication and presentation skills are essential.
• Must have the ability to exercise critical thinking and logical reasoning, to understand and convey the conceptual framework underlying health service reporting, including the conceptual and operational differences between Health Plan products.
• Must comprehend the structural differences among the internal databases and construct conceptual and technical approaches to bridge gaps in database differences to develop programming requests.
• Requires ability to interpret and apply information from multiple sources in responding to business questions.
• Needs to seek input and negotiate consensus from appropriate Health Plan staff and managers, both within and external to the department
• Ability to apply methodological design to data analysis and rate calculations
• Proficient in Microsoft suite of products, and demonstrated ability to learn new technical tools and data
• Demonstrated ability to effectively work on multiple projects simultaneously; both independently and as part of a team

Working Conditions and Additional Requirements (include special requirements, e.g., lifting, travel):

• Fast-paced environment handling multiple demands.
• Work on a personal computer approximately 80% of the time. Open cubicle work setting.
• Must be able to work under normal office conditions and work from home as required.
• Work may require simultaneous use of a telephone/headset and PC/keyboard and sitting for extended durations.
• May be required to work additional hours beyond standard work schedule.

The above statements are intended to describe the general nature and level of work being performed by employees assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties and skills required of employees assigned to this position. Management retains the discretion to add to or change the duties of the position at any time.

Compensation & Total Rewards Overview

As part of our comprehensive total rewards program, colleagues are also eligible for variable pay. Eligibility for any bonus, commission, benefits, or any other form of compensation and benefits remains in the Company's sole discretion and may be modified at the Company’s sole discretion, consistent with the law.

Point32Health offers their Colleagues a competitive and comprehensive total rewards package which currently includes:

• Medical, dental and vision coverage

• Retirement plans

• Paid time off

• Employer-paid life and disability insurance with additional buy-up coverage options

• Tuition program

• Well-being benefits

• Full suite of benefits to support career development, individual & family health, and financial health

For more details on our total rewards programs, visit https://www.point32health.org/careers/benefits/

Commitment to Diversity, Equity, Inclusion, Accessibility (DEIA) and Health Equity

Point32Health is committed to making diversity, equity, and inclusion part of everything we do—from product design to the workforce driving that innovation. Our DEI strategy is deeply connected to our core values and will evolve as the changing nature of work shifts. Programming, events, and an inclusion infrastructure play a role in how we spread cultural awareness, train people leaders on engaging with their teams and provide parameters on how to recruit and retain talented and dynamic talent. We welcome all applicants and qualified individuals, who will receive consideration for employment without regard to race, color, religion, gender, gender identity or expression, sexual orientation, national origin, genetics, disability, age, or veteran status.

Who We Are

Point32Health is a leading health and wellbeing organization, delivering an ever-better personalized health care experience to everyone in our communities. At Point32Health, we are building on the quality, nonprofit heritage of our founding organizations, Tufts Health Plan and Harvard Pilgrim Health Care, where we leverage our experience and expertise to help people find their version of healthier living through a broad range of health plans and tools that make navigating health and wellbeing easier.

We enjoy the important work we do every day in service to our members, partners, colleagues and communities.

Scam alert: Point32Health has recently become aware of job posting scams where unauthorized individuals posing as Point32Health recruiters have placed job advertisements and reached out to potential candidates. These advertisements or individuals may ask the applicant to make a payment. Point32Health would never ask an applicant to make a payment related to a job application or job offer, or to pay for workplace equipment. If you have any concerns about the legitimacy of a job posting or recruiting contact, you may contact TA_operations@point32health.org.

This job has been posted by Ignyte AI on behalf of Point32Health. Ignyte AI is committed to the fundamental principle of equal opportunity and equal treatment for every prospective and current employee. It is the policy of Ignyte AI not to discriminate based on race, color, national or ethnic origin, ancestry, age, religion, creed, disability, sex and gender, sexual orientation, gender identity and/or expression, military or veteran status, or any other characteristic protected under applicable federal, state or local law.