Quality and Training Analyst

Role Overview

• Monitors the internal and external quality improvement (QI) initiatives to continuously improve the quality and efficiency for members, providers, and populations
• Provides data analysis, reporting, and program evaluation support
• Identifies opportunities for quality improvement and facilitates quality committee initiatives to support best practices, recommendations, and incorporation into staff training and development
• Develops division quality measures and management metrics with leadership and analytics teams (e.g. scorecards, dashboards)
• Researches and summarizes clinical quality guidelines to inform evidence-based clinical decision-making that could impact workflow changes
• Supports department in maintaining compliance with accreditation standards, including development, review and revision of existing departmental policies and reports
• Trains staff on quality standards, procedures, and metrics
• Leads department Quality Improvement Committee meetings and develops topics and/or presents on quality issues to leadership and management
• Aggregates data to provide overall program metrics and client reports, collaborating with organization stakeholders to validate data integrity and ensure compliance with accreditation standards
• Participates in service recovery, problem identification, and root cause analysis; documents issues; identifies potential solutions or countermeasures; and elevates to leadership
• Leads and participates in performance improvement processes and uses Lean tools to support this work

Requirements

• Bachelor’s Degree in nursing or public health
• 5 years of experience in healthcare program evaluation and/or quality improvement role
• 3 years of experience in program evaluation in health insurance, population health, corporate health, and/or community healthcare settings
• 1 year of quality management, accreditation, and/or regulatory and compliance experience
• Ability to organize and report data with graphics, charts, and descriptive analysis
• Ability to work as a change agent to influence member, staff, and provider decisions
• Ability to prioritize multiple competing projects
• Critical thinking, problem solving, and decision making skills
• Computer literacy and advanced proficiency in Microsoft Office Suite, Excel, Word, PowerPoint, and Outlook
• Database skills (statistical concepts, data management, variance analysis)
• Demonstrated ability to self-evaluate and high level of emotional intelligence
• Familiarity with Six Sigma and Lean concepts
• Familiar with data analytics tools and predictive modeling
• Familiarity with Clinical Care Guidelines (e.g. MCG, InterQual, ChangeHealthcare)
• Skillset to include clinical expertise and business acumen
• Understanding of basic statistical concepts and application
• Willing and capable of learning and applying new technology to quality improvement needs
• Certified Professional in Healthcare Quality
• National Association for Healthcare Quality within 2 Years
• RN
• Licensed Registered Nurse_PA
• State of Pennsylvania Upon Hire

Benefits

• Health insurance
• 401(k) matching
• Flexible work hours
• Paid time off