PacificSource is looking to improve the quality of care its members receive by analyzing data to drive results, improve or maintain quality performance, outcomes, and/or ratings.
Requirements
- Minimum of 3 years of experience in data analysis or a related field required.
- Proven proficiency in data analysis tools and software (e.g., Excel, SAS, SQL) and data visualization/analytics tools (Tableau, Power BI) required.
- Knowledge of CMS Stars rating and OHA Quality Incentive measures including HEDIS, CAHPS, PQA/Pharmacy, HOS, and Display measures.
- Demonstrated skills in quality improvement concepts, healthcare data analysis, data mining methods and the identification of population health issues, trends, and health disparities using healthcare data sources.
- Demonstrated ability to analyze complex data sets, identify patterns, and drive actionable insights.
- Familiarity with statistical analysis and machine learning techniques is a plus.
- Ability to identify and resolve technical issues in a timely manner.
Responsibilities
- Collect, analyze, and interpret quality performance and results using statistical techniques.
- Generate regular reports on performance metrics, trends, and areas for improvement.
- Develop and maintain dashboards to track key performance indicators (KPI).
- Execute quantitative analyses that translate data into actionable insights.
- Review reports and performance indicators to improve quality ratings.
- Provide analytical and data-driven, decision-making support for key projects.
- Identify opportunities for improvement in quality ratings and measures.
Other
- Collaborate with cross-functional teams to develop and implement action plans.
- Communicate findings on a regular basis to all levels of business and management.
- Stay apprised of changes made by regulatory and governing bodes to relevant program guidelines, methodology, and regulations.
- Interpret policy changes and model impacts to plan performance and operations.
- Work closely with internal departments, including clinical, operations, and customer service teams, to align quality improvement efforts.