Job Description

Awarded the Best Place to Work 2021, Blue Cross Blue Shield of Arizona helps to fulfill its mission of improving the quality of life of Arizonans by delivering a variety of health insurance products and services to meet the diverse needs of individuals, families, and small and large businesses as well as providing information and tools to help individuals make better health decisions.

This remote work opportunity requires residency, and work to be performed, within the State of Arizona.

The remote work opportunity requires residency, and work to be performed within the State of Arizona

PURPOSE OF THE JOB 

The Manager, Quality Metrics will provide direction for a team of data analysts and oversee the work of an analytics department to ensure timely availability of accurate performance metrics, presented in a format understandable to various audiences. 

 

QUALIFICATIONS  

  • Familiarity with AHCCCS Medicaid, NCQA HEDIS, and CMS Medicare Stars Ratings is desirable 

  • Strong SQL skills, ability to perform effective querying involving multiple tables and subqueries 

 

REQUIRED QUALIFICATIONS 

Required Work Experience 

  • Minimum of 4 years related experience.  

Required Education 

  • Bachelor’s degree in Data Analytics, Health informatics, Epidemiology, Public Health, Biostatistics, Statistics, Applied Math, Data Science, Business intelligence or other related field 

Required Licenses 

  • N/A 

Required Certifications 

  • N/A 

 

PREFERRED QUALIFICATIONS 

Preferred Work Experience 

  • Experience working with HEDIS, CMS or other related metrics is strongly preferred. 

Preferred Education 

  • Master’s degree 

Preferred Licenses 

  • N/A 

Preferred Certifications 

  • N/A 

 

 ESSENTIAL JOB FUNCTIONS AND RESPONSIBILITIES 

  • Lead the development of processes for effective data analysis and reporting 

  • Manage the creation and maintenance of meaningful analytics, visualization, reports, and presentations most appropriate to users based on their role that enable insights to actionable next steps. 

  • Oversees ad-hoc reports and analytic support, using project management tools to gather user requirements and confirm user acceptance.  

  • Oversee the data/report requests process: tracking requests submitted, prioritization, approval, etc. 

  • Leads automation of business processes, such as on-demand reports and interactive dashboards; identifies and implements opportunities to streamline and improve processes.  

  • Maintains a Stars predictive model and reports Stars data to CMS; maintains associated written procedures. 

  • Implements ongoing processes to QA performance data and vendor reports/data; addresses gaps or inaccuracies with vendor; maintains associated written procedures; Maintains a QA procedure to ensure information reported is highly accurate. 

  • Monitors changes in regulatory contractual requirements related to performance measures, initiates change requests with data vendor, identifies organizational impacts and implements necessary organizational and reporting changes. 

  • Builds a first-in-class quality analytics program using creative, innovative strategies and best practices. 

  • Builds infrastructure and lean processes to ensure sustainability and advance the department.  

  • Provide training, orientation, performance appraisals, hiring and disciplinary action of the analytical staff; Ensures team develops new data competencies.  

  • Represents team at meetings with peers, executives, vendors and other stakeholders; presents at meetings as needed.  

  • Provide oversight and leadership in developing statistical analyses to support the Quality Department.  

  • Present analyses to stakeholders in both internal and external meetings.  

  • Provide insight, advise quality improvement teams, and respond to regulators’ requests on quality metrics through presentations, detailed narratives, etc. 

 

COMPETENCIES 

REQUIRED COMPETENCIES 

Required Job Skills 

  • Excellent communication, collaboration, and delegation skills. 

  • Proficiency in project management 

  • Ability to think analytically to resolve issues; solution-focused mindset; creative and innovative 

  • Ability to manage multiple tasks and prioritize work to adhere to deadlines and identified time frames 

  • Ability to learn new applications 

Required Professional Competencies 

  • N/A 

Required Leadership Experience and Competencies 

  • N/A 

 

PREFERRED COMPETENCIES 

Preferred Job Skills 

  • N/A 

Preferred Professional Competencies 

  • N/A 

Preferred Leadership Experience and Competencies 

  • N/A 

CORPORATE RESPONSIBILITIES 

Comply with BCBSAZ corporate and departmental policies and procedures, including, but not limited to Code Blue, Compliance, HIPAA, Computer Responsibility, Accreditation Standards, Attendance, Staff Qualifications and Quality Management Accountabilities. 

Our Commitment

BCBSAZ does not discriminate in hiring or employment on the basis of race, ethnicity, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, protected veteran status or any other protected group.

Thank you for your interest in Blue Cross Blue Shield of Arizona.  For more information on our company, see azblue.com.  If interested in this position, please apply.

Application Instructions

Please click on the link below to apply for this position. A new window will open and direct you to apply at our corporate careers page. We look forward to hearing from you!

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