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Senior Quality Data Analyst - Growing Healthcare Organization ! Hybrid Role

Company: Fallon Community Health Plan
Location: Worcester
Posted on: August 7, 2022

Job Description:

Senior Quality Data Analyst - Growing Healthcare Organization ! Hybrid RoleUS-MA-WorcesterJob ID: 6854Type: Full Time# of Openings: 1Category: QualityFallon HealthOverviewAbout Fallon Health:Founded in 1977, Fallon Health is a leading health care services organization that supports the diverse and changing needs of those we serve. In addition to offering innovative health insurance solutions and a variety of Medicaid and Medicare products, we excel in creating unique health care programs and services that provide coordinated, integrated care for seniors and individuals with complex health needs. Fallon has consistently ranked among the nation's top health plans, and is accredited by the National Committee for Quality Assurance for its HMO, Medicare Advantage and Medicaid products. For more information, visit www.fallonhealth.org.Summary:Under the general direction of the Director, Quality Data Systems, is responsible for data collection, analysis and reporting of quality projects for the Quality Department. Responsible for the calculation, documentation and reporting of assigned measures within the CMS 5 STAR measurement system and Healthcare Effectiveness Data and Information Set (HEDIS). Additional data managment responsibilites include the design and maintenance of software programs used to manage data sources for departmental quality initiatives. In addition to these specific areas, this position is responsible for providing technical, database and statistical expertise to support projects for the Quality Department. ResponsibilitiesParticipates in the planning, executing and reporting of the annual HEDIS process, submission and results. Develops Data mapping logic from multiple data sources, including enrollment, claims, pharmacy, lab and encounter data and peforms data validation to support incoming electronic health information and outgoing HEDIS vendor input specifications. Provides supporting documentation for compliance audit to verify processes and procedures as requested by the external audit firm. Responsible for providing documentation for assigned sections of NCQA's Roadmap (Record of Administration, Data Management and Processes) to certified HEDIS auditors.Provides Quality measure and dashboard reporting for a variety of stakeholders aimed at measuring, analysing and improving clinical quality of Fallon Health members. Subject matter expert of the HEDIS technical specifications, HEDIS vendor input specifications and MHDC Quality measure stand format.Participates in the completion of NCQA's Interactive Data Submission System.QualificationsEducation, Licenses, certification and experience requirements:Master's Degree in business, healthcare or other related field preferred Minimum 3-5 years' experience in Managed Care environment with responsibilities for report production, data analysis and validation as well as working knowledge with statistical analysis, trending techniques, and investigative research. 3-5 years experience with SAS or similar software Working knowledge of the following software applications required Fallon Health Vaccination Requirements:To protect the health and safety of our workforce, members and communities we serve, Fallon Health now requires all employees to disclose COVID-19 vaccination status. As of 2/1/2022, all roles not designated as "Remote" require full COVID-19 vaccination and Fallon Health will obtain the necessary information from candidates prior to employment to ensure compliance. Failure to meet the vaccination requirement may result in rescission of an employment offer or termination of employment. Fallon Health provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. pm16PI187960573

Keywords: Fallon Community Health Plan, Worcester , Senior Quality Data Analyst - Growing Healthcare Organization ! Hybrid Role, Healthcare , Worcester, Massachusetts

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