Quality Analyst VBC

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Job description

Position Summary:
The Quality Analyst is responsible for organizing and processing data to support quality reporting requirements across all Value Based Care and Population Health focused arrangements. The Quality Data Coordinator is responsible for the collection of data and development of reports that provide insights for action planning and improvement efforts.

Responsibilities:
Essential Functions
• Possesses a clear understanding of standard measure specifications, such as HEDIS and CMS, and maintains working knowledge of individual Value Based Care contract measures and reporting requirements.
• Navigates electronic health record, formats data tables, performs data via queries, and creates presentations via PowerPoint to share findings with a high level of proficiency.
• Produces quality metric reports and member level datasets for all providers to support improvement initiatives, including assisting in manual chart audits and validations for annual reporting of quality metrics to insurance payers.
• Completes monthly reports for membership, utilization, patient outcomes, and other quality metrics utilizing multiple systems to extract information.
• Reviews, analyzes, and modifies data as necessary to meet both internal and external customer needs, thereby leading to better decision-making, process improvements, and effective program implementation.
• Collaborates with the ELLiE Healthy Planet team to resolve possible conflicts related to appropriate data collection in the Comprehensive Health Record (CHR) system to help support and meet specific quality metrics.
• Utilizes the Microsoft Office software suite (specifically, Excel, PowerPoint, and Word) at a high level of proficiency, including the ability to perform analyses, develop clear and informative presentations, and communicate findings.
• Proactively manages payer quality measure reports, identifying opportunities and presenting findings to leadership and collaborates with team members to ensure data and reports meet contract requirements.
• Responsible for creating or maintaining metric or performance trackers to support departmental quality initiatives, as needed.
• Monitors gaps in care lists provided from internal and external sources to help facilitate action plans for improved performance.
• Coordinates with team members to troubleshoot data discrepancies and facilitate data quality improvement.
• Performs clinical chart abstractions and reviews population health platforms for gap closure, audit, and data validation efforts.
• Develops member detailed reports that are used to initiate patient engagement strategies to achieve metric objectives.
• Provides additional data development support for special projects, as needed.
• Collects and collates data on quality and efficiency on a regular basis.
• Attends payer meetings as a resource, participating in discussions regarding quality data and reporting needs, when needed.
• Tests and refines workflows to support sustainable functions for the quality department.
• Embraces, communicates, and promotes effective change to improvement team dynamics and day-to-day workflows.
• Maintains compliance with all Orlando Health policies and procedures.
• Maintains reasonably regular, punctual attendance consistent with Orlando Health policies, the ADA, FMLA and other federal, state and local standards.

Qualifications:
Education/Training
High School Diploma or equivalent.

Licensure/Certification
None.

Experience

Proficiency in Microsoft Office products, with a basic to intermediate Microsoft Excel skill level. Strong written and organizational skills. Previous experience with provider education and collaboration preferred.

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