Manager, Quality Metrics Analytics - Remote

• 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 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 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. 

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 Job Skills 

• N/A 

Preferred Professional Competencies 

• N/A 

Preferred Leadership Experience and Competencies 

• N/A