Serve as a trusted partner and advisor to business leaders.
Manage communications with external providers and vendor partners to drive improvement in clinical quality, access, member experience, and other performance outcomes.
Develop robust business cases, visual insights, and presentations to communicate clear quality improvement objectives, metric definitions, evaluation methods, and performance results to various audiences.
Present clear, data-driven narratives, visualizations, and recommendations to business leaders and stakeholders to drive informed business decisions.
Develop project plans, timelines, and implements project objectives on time from start to finish.
Collaborate with internal and external stakeholders to translate business needs into requirements.
Perform analyses using healthcare claims, clinical, and financial data in a relational database environment, including development of SQL queries and stored procedures.
Develop reports and dashboards by combining and aggregating data from multiple sources.
Interpret results and make recommendations for improved processes, metric definitions, and evaluation methods.
Perform extensive data validation to ensure results meet stakeholder needs.
Prepare documentation such as process diagrams, wireframes, metric definitions, and pseudocode.
Monitor availability, consistency, and accuracy of business data.
Provide feedback and advice to management to guide decision making.
Requirements
7+ years of healthcare payor or provider experience managing analytics, quality measurement and improvement initiatives.
5+ years of experience conducting analysis with healthcare claims and services data.
5+ years of experience with SQL programming in a data warehouse or big data analytics environment.
5+ years of experience developing business cases, visual insights, and PowerPoint presentations to drive business decision making.
5+ years of experience analyzing data with Excel, BI and data wrangling tools (Power BI, Tableau, Alteryx, Dataiku, or similar).
5+ years of experience developing KPIs for performance and quality improvement initiatives.
Strong knowledge of user-centered design principles and visualization best practices.
In-depth knowledge of healthcare industry standards, regulations, and data privacy.
Strong analytical and problem-solving skills are essential, as well as time management, attention to detail, and adaptability.
Strong project management and organization skills.
Excellent communication skills, with the ability to collaborate effectively with cross-functional teams and present findings and results to various audiences.
Ability to work independently and effectively to drive projects to completion.
Ability to manage conflicting priorities and multiple projects concurrently.
An ability to travel up to 10% for meetings as needed