Quality Improvement Analyst

Meridian Detroit , MI 48222

Posted 2 months ago

Overview

Who we are:

Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.

Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

A Day in the Life of a Quality Improvement Analyst:

This position works closely with the Manager of Quality Improvement to support the data collection and analysis requirements for the quality improvement and disease management programs. This position coordinates all aspects of data management and analytical tactics for the quality and disease management departments including the HEDIS data collection and analysis as well as other quality improvement data collection activities.

Responsibilities

  • Coordinate design and execution of data collection activities necessary to identify trends and important aspects of care

  • Provide expertise to assist with implementation of process changes necessary to improve the quality and accuracy of data captured by the system

  • Compile, analyze, and interpret data collected from monitoring activities. Identify opportunities for improvement based on data analysis.

  • Translate data into meaningful information. Track, trend and report findings to the QIC and its subcommittees, as well as administrative and executive leadership, as appropriate.

  • Serve as application resource expert for quality and disease management and function as principal communication coordinator with IS related to specifications, design and testing

  • Coordinate the development of data analysis and collection tools for Healthcare Effectiveness Data and Information Set (HEDIS) reporting and other QI efforts

  • Review administrative data for problems and inconsistencies associated with HEDIS and/or other quality improvement efforts specifications (e.g. coding and/or claims issues)

  • Work in concert with IS in the design and implementation of the patient and provider profiling systems as applicable to quality and disease management needs

  • Support QIA activities in progress by facilitating the translation of review criteria into data collection methodologies and assuring the accuracy of monitoring tools

  • Utilize drill down and root cause methodologies to review data statistics and identify opportunities for improvement for QIAs or other quality improvement efforts

  • Develop reporting systems for data presented to the State, National Committee for Quality Assurance (NCQA), URAC or general accreditation and other entities

  • Assist with the development of data collection tools and training materials for quality and disease management initiatives

  • Consistently demonstrate compliance with HIPAA regulations, professional conduct and ethical practice

  • Ability to travel

Qualifications

What you can bring to Meridian:

  • Bachelor's degree in public health, data analysis, nursing or other related health care field or Fellow Designation from the Academy of Healthcare Management (AHM) is required.

  • Experience in health care data analysis/quality management/managed care is required

  • Experience working on team projects is required

  • Demonstrable working knowledge of HEDIS reporting and NCQA, URAC, or general accreditation requirements

  • Knowledge of research methods including use of the Internet

  • Knowledge of continuous quality improvement strategies and practical application methodologies

  • Strong computer skills including competency in Microsoft Word, Excel, PowerPoint, query tools and databases (i.e. Oracle) preferred

  • Excellent interpersonal and communications skills, both written and oral

  • Ability to integrate clinical knowledge and skills when analyzing complex tasks, systems, and problems

  • Ability to analyze and present data in a meaningful way

  • Ability to produce written specifications for reports and coordinate with information technology staff (i.e. programmers)

What Meridian can offer you:

  • Ourhealthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members.

  • Opportunity to work with the industry's leading technologies and participate in unique projects, demonstrations, conferences, and exclusive learning opportunities.

  • Meridian offers 401k matching that is above the national average.

  • Full-time Meridian employees are eligible fortuition reimbursement towards Bachelor's or Master's degrees.

  • Meridian was named

Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian.

Equal Opportunity Employer

#MSTR


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