Job Ref: 58100
Category: Quality Assurance
Department: PARTNERSHIP IN CARE
Location: 160 Water St. #3, New York, NY 10038
Job Type: Regular
Employment Type: Full-Time
Hire In Rate: $60,770.00
Salary Range: $60,770.00 - $60,770.00
About NYC Health + Hospitals
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.
The primary function of the Quality Analyst position is to support the data analysis, monitoring, evaluation and reporting activities within the Partnership in Care (PIC) department. This position will conduct ongoing analyses that will support PIC operations in five key areas: regulatory compliance, care management, quality/performance measurement, special projects/grants, and administrative functions. The role will support the strategic goals of the PIC department to ensure that all MetroPlus HIV positive members are engaged in care, virally suppressed, and receiving appropriate services The role requires working knowledge of SAS, SQL, Tableau, MS Access, and MS Excel.
- Designs, coordinates, and implements analytical business and technology solutions, i.e., MS Access databases, SAS, SQL programs, Crystal Reports to support PIC operations.
- Develops a comprehensive data reporting, evaluation, and monitoring plan for PIC department.
- Analyzes and monitors contractual compliance and business operations to evaluate inefficiencies (e.g. member enrollment, eligibility verification, retention).
- Analyzes monthly claims data alongside other data sources (gaps in care, CRG scores, etc.) to create member profiles and acuity scores.
- Identifies, prioritizes, and distributes members based on risk and acuity for outreach to the care management team.
- Measures and tracks key performance indicators and targets to effectively monitor department activities including productivity and quality outcomes.
- Performs extraction, import, and export of data from diverse data sources including various database applications.
- Packages data from a variety of reports into a monthly and quarterly departmental dashboard
- Provides training to internal and external staff regarding analyses, reports, or other relevant topics.
- Ensures accuracy and conducts validation of all reports and analyses.
- Performs statistical analyses to support monitoring and evaluation of PIC department.
- Develops and prepares reports, business presentations, and other materials.
- Assist with the identification, collection, input, and assembly of documents as required for external and internal audits.
- Assist with analyses and reporting for special projects as assigned.
- Attends approved in-service and external education and training as per department directives.
- Master’s degree in public health, health administration, business administration, or information technology preferred. Bachelor’s degree required.
- A minimum of three years analytics, programming, application, or reporting development experience is required.
- Experience using analytics/BI packages (e.g. SAS, SQL, R, Cognos, Tableau, etc.) is required.
- Must have advanced working knowledge of Microsoft Office application including Excel and Access.
- Prefer experience and knowledge of Managed Care plan operations or Health Services administration.
- Knowledge of concerns of persons living with HIV/AIDS is preferred.
- Displays strong communication, interpersonal, and organizational skills across all levels coupled with effective problem solving, conceptual thinking, quantitative, and analytical skills.
- Integrity and Trust
- Customer Focus
- Functional/Technical skills
- Written/Oral Communication