Quality Analyst (Hybrid)

About the role

The Quality Analyst is responsible for defining, measuring, analyzing, and evaluating population health, while prioritizing, developing, and operationalizing innovative initiatives to improve the quality of care and experience, resulting in industry-leading outcomes at a population level.

Work location

This role is hybrid and requires the incumbent to work a portion of the week from home and a portion of the week at a CareFirst location in the greater Baltimore/Washington metropolitan area, based on business needs and work activities/deliverables.

Essential functions

• Act as the organization's subject matter expert in population health, measurement science, accreditation, and quality improvement. Utilize the framework of NCQA Accreditation to accomplish and document work products.
• Define, measure, and document the performance of the health plan in facilitating quality healthcare, positive outcomes, and excellent experience for members.
• Analyze and evaluate health plan performance using qualitative and quantitative methodologies, producing actionable and insightful reports and visualizations addressing population health quality opportunities.
• Prioritize, develop, and operationalize these opportunities in collaboration with other areas of the organization into innovative programs and initiatives.

Qualifications

• Bachelor's Degree in population health, public health, healthcare administration, business administration, health policy, economics, statistics, mathematics, data science, or a related field.
• In lieu of a Bachelor's degree, an additional 4 years of relevant work experience is required in addition to the required work experience.
• 3 years professional experience in a business environment (public health, health insurance, management consulting fields preferred); evidence of progressing levels of responsibility.

Preferred qualifications

• Certification in Quality or Process Improvement Methods.
• Direct experience with accreditation, HEDIS, CAHPS and other quality related activities in a healthcare related environment and/or payor organization.
• Data analytics experience working with large data sets to answer clinical, operational, or business questions; prior experience with healthcare data expected.
• RN-BC - Certified General Nursing Practice preferred.
• LPN-Diploma preferred.

Knowledge, skills, and abilities

• Knowledge of qualitative and quantitative data analyses and presentations.
• Fluent in the use of Microsoft tools including Excel, Word, PowerPoint and Outlook.
• Knowledge of healthcare claims, survey, clinical, and health data.
• Remote Electronic Medical Record experience.
• Ambulatory practice experience is a must.
• Must be able to meet established deadlines and handle multiple customer service demands from internal and external customers, within set expectations for service excellence.
• Must be able to effectively communicate and provide positive customer service to every internal and external customer, including customers who may be demanding or otherwise challenging.

Pay

Salary range: $63,576 - $126,269

Schedule

Hybrid work model in the greater Baltimore/Washington metropolitan area. Travel to provider offices for chart retrieval may be required (estimated 10%).

Benefits

CareFirst offers a comprehensive benefits package, various incentive programs/plans, and 401k contribution programs/plans (all benefits/incentives are subject to eligibility requirements).