Oregon Health Authority (OHA) needs to build a Quality Assurance System for Medicaid Fee-For-Services (FFS) and the Agency with Choice program to inform the use of Medicaid resources and improve quality across the state.
Requirements
- Five years of research experience using computerized applications to independently gather, compile, and analyze data and prepare narrative or statistical reports.
- Two of the five years must have included coordinating complex research projects.
- A Bachelor's Degree in any disciplines that included six-quarter units in statistics or quantitative analysis methods and procedures, and three years experience using computerized applications to independently gather, compile, and analyze data and prepare narrative or statistical reports.
- Two of the three years must have included coordinating complex research projects.
- Experience using health care expenditure, utilization, quality and outcomes data in large information systems.
- Experience presenting and articulating the value and relevance of research and evaluation data and data mapping to facilitate quality assurance, strategic planning, and decision-making.
- Demonstrated ability to use advanced statistical and analytic tools such as SQL, R, SPSS, SAS, Power BI, Tableau, Excel, and related applications.
Responsibilities
- Leads the design, development, implementation, and evaluation of research to inform OHA on how to use Medicaid resources to build a Quality Assurance System for Medicaid Fee-For Services (FFS) and the Agency with Choice program.
- Develops evaluation processes, tools, and metrics to assess FFS program quality and establish statewide standards as part of Medicaid FFS transformation, the Agency with Choice program, and Oregon Health Plan quality improvement.
- Develop a new member- and provider-focused statewide quality assurance system based on health equity and outcome metrics.
- Create quantitative indicators and qualitative process improvement data to establish standards for member access, provider quality, network adequacy, communication, operational processes including standardized provider rates, and integration of member and community voice in rulemaking.
- Collaborates with internal and external partners to integrate evaluation processes, support rate standardization, and develop contract compliance policies.
- Experience and knowledge evaluating and synthesizing quantitative and qualitative data to analyze and measure the effectiveness, efficiency, and impact of administrative and technical programs within the context of health policy / healthcare services.
- Experience using health care expenditure, utilization, quality and outcomes data in large information systems.
Other
- Experience supporting the development and implementation of policies and programs at the community, state, and/or national level that advance health equity (address systemic health disparities, expand culturally responsive and inclusive services, factor in social determinants of health) and elevate the voice of community and those with lived experience.
- Knowledge of legislative and regulatory processes; specific knowledge of Oregon Administrative Rules and Oregon Revised Statutes is valued in this position.
- Knowledge of health services delivery systems, particularly the Oregon Health Plan/ Medicaid administration in Oregon.
- Strong oral and written communication skills across a variety of forums; experience communicating qualitative and quantitative information, verbal and written, that are accessible to and understood by audiences with different levels of comprehension or interest and that are culturally responsive, inclusive, and appropriate.
- Ability to provide organizational leadership to foster inter- and cross-agency collaboration and to shape systems-wide community-centered policies, programs, and continuous (performance / quality / process) improvement strategies.
