Analyst Quality Improvement

Job Number: 2948

Workplace Type:

Position Title: Analyst Quality Improvement

External Description:

Analyst Quality Improvement

Alignment Healthcare was founded with a mission to revolutionize health care with a serving heart culture. Through its unique integrated care delivery models, deep physician partnerships and use of proprietary technologies, Alignment is committed to transforming health care one person at a time.

By becoming a part of the Alignment Healthcare team, you will provide members with the quality of care they truly need and deserve. We believe that great work comes from people who are inspired to be their best. We have built a team of talented and experienced people who are passionate about transforming the lives of the seniors we serve. In this fast-growing company, you will find ample room for growth and innovation alongside the Alignment community.

 

Position Summary:
This position is responsible for supporting the CMS Star program improvements through data analysis.  In collaboration with the Quality Improvement Supervisor, analyze complex data and information to provide meaningful results, identifying success factors and improvement opportunities, and suggesting potential solutions. This position will leverage data from internal and external sources, understand relevant differences between each data source, and provide meaningful/actionable interpretation of results. This position will support the identification and development of databases to support business functions for the Medicare products, using enrollment, medical and pharmacy claims information.

 

This position will be supporting analytical projects in AHC’s Quality Improvement Medicare Stars team and will be responsible for conducting effectiveness studies on various program/campaigns to improve Stars Rating. Medicare stars team is engaged in all aspects of the analytic lifecycle from program ideation, financial support to the implementation and provides an open environment to identify/implement new studies. The individual in this position will take a lead in providing recommendations based on the analytic findings.

 

General Duties/Responsibilities:

(May include but are not limited to)

 

• Performs complex analysis of the data.
• Research, analyze, and interpret statistical data and provides technical assistance to other staff.
• Acts as a resource for other members within AHC on business issues and may be responsible for training and guidance of other employees.
• Investigates opportunities for expanded data collection that are needed elements for CMS Star Rating Measures.
• Independently manages the retrieval and analysis of data, and issues that may arise on multiple tasks or projects with limited management involvement.
• Support of Medicare Stars business initiatives that drive short- and long-term objectives towards achieving the overall 5 Star goal.
• Designs and conducts analyses and outcome studies using healthcare claims, pharmacy and lab data, employing appropriate research designs and statistical methods.
• Develops, validates and executes algorithms that answer applied research and business questions.

 

Minimum Requirements:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.  The requirements listed below are representative of the knowledge, skill, and/or ability required.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. Minimum Experience:
   1. 1-year healthcare analytics or related job experience.
2. Education/Licensure:
   1. Bachelor's degree in a quantitative field such as statistics, mathematics, or public health
3. Other:

1. 1. Demonstrated analytic and problem-solving skills
   2. Proficiency in Microsoft software applications such as Word, PowerPoint, Excel, Access
   3. Basic to intermediate knowledge of SQL or PowerBI
   4. Demonstrated ability to design, evaluate and interpret complex data sets.
   5. Demonstrated ability to handle multiple tasks with competing priorities.
   6. Excellent written and verbal communication skills and with an ability to interpret and communicate analytical information to both individuals and groups in a clear and concise manner.
   7. Demonstrated ability to work effectively both independently and in a team setting with individuals having diverse professional backgrounds including business, technical and/or clinical.
   8. Preferred:

1. Knowledge of health care performance measurement; CMS STAR ratings strongly preferred.
2. Knowledge of HEDIS measures or clinical metrics.

• Demonstrated ability to present complex technical information to non-technical audiences and to senior decision-makers.

1. Work Environment
2. 1. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Essential Physical Functions:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and/or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

 

Alignment Healthcare, LLC is proud to practice Equal Employment Opportunity and Affirmative Action. We are looking for diversity in qualified candidates for employment: Minority/Female/Disable/Protected Veteran.

If you require any reasonable accommodation under the Americans with Disabilities Act (ADA) in completing the online application, interviewing, completing any pre-employment testing or otherwise participating in the employee selection process, please contact [email protected].

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: Analyst Quality Improvement

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].