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Position: Director - Clinical Quality Analytics
Institution: Blue Shield of California
Department: Information Technology
Location: San Francisco, California, United States
Duties: Oversee all aspects of HEDIS production, including data extraction, processing, medical record review, survey, audit, and report submission to NCQA. Oversee care gap reporting for member and provider intervention programs. Deliver contractual quality reporting to provider partners timely to improve quality ratings and for Pay for Performance programs. Identify, in collaboration with Clinical Quality teams, a set of quality of care metrics to be produced regularly. Develop and deliver these metrics on pre-determined schedule. Analyze HEDIS data, Medicare STAR rating data, and other quality of care data to identify improvement opportunities
Requirements: Bachelor’s degree in health care administration, health services research, public health, epidemiology, economics, statistics, computer science or a relevant field. Minimum three years of experience in leading HEDIS production and clinical quality measurement. Minimum three years of experience in analyzing health care insurance claims data or electronic medical record data. Minimum five years of hands-on experience in data analysis tools, including but not limited to SAS, SQL, SPSS, Access, Cognos, Tableau. Minimum three years of supervisory experience leading an analytics/research team
   
Text: Looking for a chance to do meaningful work that touches millions? Come join the hardest working, nonprofit health plan in California and help us shape the future of health care. Blue Shield of California’s Mission is to ensure all Californians have access to high-quality care at an affordable price. Blue Shield is focused on improving health care delivery by working closely with providers and making it more accessible, affordable and customer-centric. Being a mission-driven organization means we do much more than serve our 4 million members: we were the first health plan in the nation to limit our annual net income to 2 percent of revenue and return the difference to our customers and the community, and since 2005 we have contributed more than $325 million to the Blue Shield of California Foundation to improve community health and end domestic violence. We also believe that a healthier California begins with our employees, so we provide them with resources to develop and maintain a healthy lifestyle through our award-winning wellness program, Wellvolution. We're hiring smart thinkers and doers who want to work for a leader and innovator in the challenging, ever-changing healthcare space. Come and help us make health care better for everyone.',' The Director, Clinical Quality Analytics is responsible for HEDIS production and for providing data and analytic support for clinical quality programs. This position reports to the VP Enterprise Analytics and dotted line to the VP Clinical Quality within the Healthcare Quality and Affordability organization (HCQA). This position interfaces and partners with the Quality Management and Medicare Star Leadership teams and cross functional business partners to provide data and analytical support for clinical quality projects, including opportunity identification, performance and analytical reporting, program design, impact analysis, and program evaluation. The success of this leadership role results in improve quality ratings, health plan accreditation status, enhance revenue, and reduce administrative and costs of healthcare delivery. The Director, Quality Analytics manages a team of professional employees with extensive knowledge in clinical quality measurement methodology, HEDIS production, medical record review, NCQA Accreditation, Medicare Star reporting, and regulatory reporting requirements. The position is based in one of our main CA offices (San Francisco or Woodland Hills). Specific duties include: Oversee all aspects of HEDIS production, including data extraction, processing, medical record review, survey, audit, and report submission to NCQA. Oversee care gap reporting for member and provider intervention programs. Deliver contractual quality reporting to provider partners timely to improve quality ratings and for Pay for Performance programs. Identify, in collaboration with Clinical Quality teams, a set of quality of care metrics to be produced regularly. Develop and deliver these metrics on pre-determined schedule. Analyze HEDIS data, Medicare STAR rating data, and other quality of care data to identify improvement opportunities. Provide consultation to Clinical Quality teams for quality improvement programs design and development. Support implementation of clinical quality projects, including estimating size of the population, potential impact, monitoring progress, reporting and evaluation. Provide, in collaboration with Clinical Quality teams, requirements for clinical quality data infrastructure to support clinical quality measurement and reporting activities. Monitor vendor-managed programs to ensure compliance with service level agreements and quality outcomes. Manage team: hiring and training, performance and salary reviews, promotions and disciplinary matters for direct reporting employees. ',' The Director, Clinical Quality Analytics is responsible for HEDIS production and for providing data and analytic support for clinical quality programs. This position reports to the VP Enterprise Analytics and dotted line to the VP Clinical Quality within the Healthcare Quality and Affordability organization (HCQA). This position interfaces and partners with the Quality Management and Medicare Star Leadership teams and cross functional business partners to provide data and analytical support for clinical quality projects, including opportunity identification, performance and analytical reporting, program design, impact analysis, and program evaluation. The success of this leadership role results in improve quality ratings, health plan accreditation status, enhance revenue, and reduce administrative and costs of healthcare delivery. The Director, Quality Analytics manages a team of professional employees with extensive knowledge in clinical quality measurement methodology, HEDIS production, medical record review, NCQA Accreditation, Medicare Star reporting, and regulatory reporting requirements. The position is based in one of our main CA offices (San Francisco or Woodland Hills). Specific duties include: Oversee all aspects of HEDIS production, including data extraction, processing, medical record review, survey, audit, and report submission to NCQA. Oversee care gap reporting for member and provider intervention programs. Deliver contractual quality reporting to provider partners timely to improve quality ratings and for Pay for Performance programs. Identify, in collaboration with Clinical Quality teams, a set of quality of care metrics to be produced regularly. Develop and deliver these metrics on pre-determined schedule. Analyze HEDIS data, Medicare STAR rating data, and other quality of care data to identify improvement opportunities. Provide consultation to Clinical Quality teams for quality improvement programs design and development. Support implementation of clinical quality projects, including estimating size of the population, potential impact, monitoring progress, reporting and evaluation. Provide, in collaboration with Clinical Quality teams, requirements for clinical quality data infrastructure to support clinical quality measurement and reporting activities. Monitor vendor-managed programs to ensure compliance with service level agreements and quality outcomes. Manage team: hiring and training, performance and salary reviews, promotions and disciplinary matters for direct reporting employees. ',' Bachelor’s degree in health care administration, health services research, public health, epidemiology, economics, statistics, computer science or a relevant field. Master’s preferred. Minimum three years of experience in leading HEDIS production and clinical quality measurement Minimum three years of experience in analyzing health care insurance claims data or electronic medical record data Minimum five years of hands-on experience in data analysis tools, including but not limited to SAS, SQL, SPSS, Access, Cognos, Tableau. Minimum three years of supervisory experience leading an analytics/ research team Preferred: 3 years of experience in program evaluation methodology, and statistical analysis. ',' Bachelor’s degree in health care administration, health services research, public health, epidemiology, economics, statistics, computer science or a relevant field. Master’s preferred. Minimum three years of experience in leading HEDIS production and clinical quality measurement Minimum three years of experience in analyzing health care insurance claims data or electronic medical record data Minimum five years of hands-on experience in data analysis tools, including but not limited to SAS, SQL, SPSS, Access, Cognos, Tableau. Minimum three years of supervisory experience leading an analytics/ research team Preferred: 3 years of experience in program evaluation methodology, and statistical analysis. ','Health Data Analysis','Health Data Analysis','United States of America-California-San Francisco','United States of America-California-San Francisco','United States of America-California-El Dorado Hills, United States of America-California-Costa Mesa, United States of America-California-San Diego, United States of America-California-Sacramento, United States of America-California-El Segundo','United States of America-California-El Dorado Hills, United States of America-California-Costa Mesa, United States of America-California-San Diego, United States of America-California-Sacramento, United States of America-California-El Segundo','Information Technology','Information Technology','Full-time','Full-time','Oct 9, 2017, 9:56:18 AM','Oct 9, 2017, 9:56:18 AM','External hires must pass a background check/drug screen. Qualified applicants with arrest records and/or conviction records will be considered for employment in a manner consistent with Federal, State and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regards to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran status or disability status and any other classification protected by Federal, State and local laws.','false','20984','20984','true','20984','false','Submission for the position: Director, Clinical Quality Analytics - (Job Number: 17002IO)','false','20984','false','true','https://bsc.taleo.net/careersection/jobdetail.ftl?job=17002IO〈=en','Director, Clinical Quality Analytics','true']);
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