Manager, Performance Improvement & Analytics - VIVA HEALTH

Manager of Performance Improvement & Analytics

Location: Birmingham, AL

Work Schedule: Hybrid schedule with onsite work at the VIVA HEALTH corporate headquarters and some work-from-home opportunities.

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan, receiving a 5 out of 5 Star rating - the highest rating a Medicare Advantage Plan can achieve and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

• Comprehensive Health, Vision, and Dental Coverage
• 401(k) Savings Plan with company match and immediate vesting
• Paid Time Off (PTO)
• 9 Paid Holidays annually plus a Floating Holiday to use as you choose
• Tuition Assistance
• Flexible Spending Accounts
• Healthcare Reimbursement Account
• Paid Parental Leave
• Community Service Time Off
• Life Insurance and Disability Coverage
• Employee Wellness Program
• Training and Development Programs to develop new skills and reach career goals
• Employee Assistance Program

See more about the benefits of working at Viva Health - https://www.vivahealth.com/careers/benefits

Job Description

The Manager, Performance Improvement & Analytics is responsible for supervision of VIVA HEALTHS strategies to maximize quality and performance measures associated with Medicare and Commercial lines of business, as well as oversee operational/ clinical analytics support for assigned departments (ex: pharmacy/ quality.) Examples of these indicators include ratings associated with the Centers for Medicare & Medicaid Services (CMS) STARS Program (HEDIS, CAHPS, HOS, etc.), member satisfaction, population health analytics, financial performance, regulatory compliance, and quality outcomes for members.

This role manages a team of analysts and works with various internal and external stakeholders to accurately collect data, design methodologies for research projects, execute a variety of complex analyses, and present key findings. The position likewise identifies and implements opportunities through detailed analysis for process improvement initiatives pertaining to areas assigned and facilitates performance improvement projects.

Key Responsibilities

• Effectively manage the conceptualization and execution of company-wide reporting (i.e., KPIs, dashboards) to report current performance on CMS Star measures and overall rating to internal and external stakeholders.
• Effectively manage the performance and outcomes of assigned analysts or other employees.
• Lead performance improvement projects through all phases of the development lifecycle.
• Lead the development and maintenance of complex data analytics and research projects related to strategies to improve assigned processes.
• Serve as Subject Matter Expert (SME) on technical, regulatory, and industry changes impacting assigned areas and effectively communicate changes to applicable stakeholders.
• Serve as SME on various complex data sets such as medical and pharmacy claim elements and eligibility data. Act as a SME on data analysis tools utilized in reporting (i.e., SQL Server, Tableau, etc.).
• Implement policies and procedures for standardized quality assurance of data exchanges.

REQUIRED:

• Bachelor's Degree in Business, Public Health, Information Systems, Medical Information Systems, or a related field
• 5 years of experience conducting complex data analysis and interpretation
• 2 years of management experience
• Knowledge of statistical analysis techniques as well as data visualization practices
• Ability to manage multiple projects or assignments within expected time constraints
• Strong presentation and oral and written communication skills
• Knowledge and understanding of quality metrics and pay for performance programs, including the CMS STARS Program
• Ability to identify and obtain data from a variety of systems and/or the ability to create the report description appropriate to obtain and report on the identified data
• Ability to facilitate and lead projects through all phases of the development lifecycle

PREFERRED:

• Masters in Business or health-related field
• Experience in Medicare Advantage Organization with experience conducting data analytics with healthcare and financial data, particularly analytics related to the CMS Star Ratings
• Lean Six Sigma, Project Management, or similar process management certification
• Knowledge of Medicare Advantage, Health Maintenance Organizations, or other Health Insurance operations
• Knowledge of database management systems, query languages, table relationships, and views
• Working Knowledge of SAS, Tableau, Crystal, or similar query tools