Job Description

Our Mission:  Provide the best value in health insurance and related health services to improve the quality of life for Arizonans.

Our Vision: 

Inspire health in Arizona as the trusted leader in delivering affordable, innovative healthcare solutions.

Our Benefits: Our benefits provide work-life balance and the flexibility you need to be your best. We offer comprehensive medical, dental, and vision coverage; a 401K savings plan; paid holidays and vacations; and much more!

Position Purpose:    

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.

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.

Education / Experience / Other Requirements

Education:   

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

Years of Experience:  

Minimum of 4 years related experience. Experience working with HEDIS, CMS or other related metrics is strongly preferred.

Specialized Knowledge:

  • 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

Skills and Abilities:

  • 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

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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