Quality Analyst
Current• Responsible for health plan quality data reporting for compliance and quality performance improvement• Participates in quality planning, measurement and evaluation activities as requested for the organization• Assists in the review and collection of measures used for department data reporting or other organization-specific measures or indicators, assuring that data is evaluated and used for performance• Compiles, reviews and reports data to support health plan quality data reporting requirements and to improve quality incentive payments for the Commercial and Medicare Advantage plans• Maintains and updates all quality data spreadesheets for all managed care plans as well as creating monthly provider scorecards and updating the gaps in care lists from the various health plans• Responsible for establishing and maintaining all outreach to members with Diabetes, Asthma, and Gaps in Care for Breast and Colon Cancer screenings• Supports the Director of Clinical Performance and Quality Management with the UM meeting responsibilities, which includes collecting data and preparing reports• Serves as indispensable team member in Population Health Management Program. Although not directly working with the members, the quality analyst assists the team with member stratification based on preset clinical criteria, maintains gaps in care reports, prepares report cards for providers and gathers data for statistical analysis of PHM Program effectiveness