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Job Details

QM Operations Data Analyst

Job Ref: 37191
Category: Quality Assurance
Department: QUALITY ASSURANCE
Location: New York, NY
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $75,000.00
Salary Range: $75,000.00 - $75,000.00

Marketing Statement

MetroPlus Health Plan provides the highest quality healthcare services to residents of Bronx, Brooklyn, Manhattan, Queens and Staten Island through a comprehensive list of products, including, but not limited to, New York State Medicaid Managed Care, Medicare, Child Health Plus, Exchange, Partnership in Care, MetroPlus Gold, Essential Plan, etc. As a wholly-owned subsidiary of NYC Health + Hospitals, the largest public health system in the United States, MetroPlus’ network includes over 27,000 primary care providers, specialists and participating clinics. For more than 30 years, MetroPlus has been committed to building strong relationships with its members and providers to enable New Yorkers to live their healthiest life.

Position Overview 
The primary function of the QM Operations Data Specialist is to support data management functions that operationally and technically support Quality Management Operations activities. The QM Operations Data Specialist should be able to work independently to develop analytical and operational business solutions. The role requires advanced working knowledge of SQL, MS Access and Excel. This position will function as the sole developer of internal tracking tools and applications that support the QM Operations In-Field Navigators as well as the collection of supplemental data for use in HEDIS/QARR reporting. The role will also mentor and train staff on all applications and reports developed. The position may also be responsible for duties tied to the development of new programs and initiatives as assigned by the Director of QM Operations. 

Job Description
  • Designs, coordinates, and implements analytical business and technology solutions, i.e. MS Access databases, SQL programs, Crystal Reports to support QM Operations activities.
  • Executes all regular transaction processes necessary to maintain QM Operations records and databases.
  • Perform extracting, importing, and exporting of data in various database applications.
  • Assists in implementation, testing, and validating of supplemental data collected from providers
  • Performs data reconciliations to identify data anomalies.
  • Provides technical mentorship to QM Ops Specialist and Quality Review Leads.
  • Functions as mid-level escalation support for all applications; Escalate data issues needing process re-engineering.
  • Assist in preparation of data reports, training materials, business presentations, publications, marketing collaterals, and other educational materials. Trains staff as necessary.
  • Technically and operationally assists in the re-design of the annual hybrid Medical Record Review (MRR) Project
  • Other duties as assigned by Director of QM Operations.
Minimum Qualifications
  • Bachelor of Science/Bachelor of Arts degree or equivalent experience is required. 
  • A minimum of 4 years programming, application or reporting development experience and analytical experience (SAS, SQL, Business Objects, MS SQL Server). 
  • Experience using analytics / BI packages (e.g. SAS, R, SQL, Cognos, Business Objects) to build client analysis solutions.
  • Must have advanced working knowledge of Microsoft Office applications including Word, Excel, PowerPoint, Visio and Access.
  • Ability to travel within the MetroPlus service area when needed.
  • Position requires individual with high degree of accuracy. Must be able to translate theoretical knowledge into practical application. 
  • Displays strong communication, interpersonal, and leadership ability across all levels coupled with effective problem solving, conceptual thinking, quantitative and analytical skills.
  • Strong written and verbal presentation as well as data analysis skills required.
  • Ability to work independently and multitask to meet deadlines.

Professional Competencies

  • Integrity and Trust
  • Customer Focus
  • Functional/Technical skills
  • Written/Oral Communication
How To Apply

If you wish to apply for this position, please apply online by clicking the "Apply Now" button or forward your resume, noting the above Job ID #, to:


MetroPlus Health Plan
Human Resources Department
160 Water Street 8th Floor
New York, NY 10038
Attn: Recruitment Unit

This is position is classified as a managerial title, in addition to a variety options for Health Benefits through MetroPlus, managerial employees receive vision, dental, gym reimbursement and life insurance benefits through the Management Benefits fund of the City of New York. Please view the benefits page for more detailed information.
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