Blue Cross And Blue Shield Association Oakland , CA 94604
Posted 3 weeks ago
Your Role
The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst
Your Work
In this role, you will:
Conduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reports
Develop documentation and create and execute workplans for analyses of high complexity
Produce analysis of high complexity under the guidance and direction of Clinical Quality Analyst
Design, build, and enhance data systems and applications so that they better serve specific reporting requirements
Identify business risks relating to report design and production
Collect data from various internal systems (example Claims processing or membership systems) and external systems (EMR/EHR) and converts those data to actionable insights to guide business decision making for BSC populations' health management and quality of care
Produce monthly provider and/or employer group specific reports based on HEDIS measures in alignment with reporting quality ratings systems such as NCQA Stars/Accreditation, Medicare Stars, Medi-Cal Managed Care Accountability Sets, Quality Transformation Initiative and Quality Rating System
Partner with the HEDIS data team, Clinical Quality Analytics and Medical Record Review teams to support HEDIS performance improvement initiatives
Blue Cross And Blue Shield Association