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Medical Quality Auditor

1 month ago


Oakland CA, United States Alameda Health System Full time

Summary SUMMARY: Facilitates ongoing measurement, data optimization, reporting, and information dissemination with a focus on data integrity, integration, standardization, analysis, and visualization; collaborates with multi-disciplinary teams and assist in the development of data management and analysis plans, monitors reporting requirements establishes guiding metrics and benchmarks for performance improvement initiatives and system-wide clinical priorities; provides clinical stakeholders data driven insights and will works closely with clinical stakeholders to produce reports to inform decision making.
DUTIES & ESSENTIAL JOB FUNCTIONS: NOTE: The following are the duties performed by employees in this classification, however, employees may perform other related duties at an equivalent level. Not all duties listed are necessarily performed by each individual in the classification.
1. Monitors the healthcare environment, identify emerging industry trends and evolving public policy/regulation and best practices.
2. Identifies and tracks clinical and operational opportunities and assist stakeholders with program planning and decision making around the use of data.
3. Supports public reporting and payment incentives programs; maintains data capture infrastructure; disseminates and educates programmatic changes to clinical and operational leadership; serves as primary contact for 3rd party vendors involved in program submissions (i.e. Patient Experience, Core Measure Submission).
4. Leverages descriptive statistics, correlations, and regression analysis to drive data driven insights.
5. Works with clinical and operational leaders to construct measurement and analytic plans for improvement initiatives and organizational goal setting; clearly defines and seeks consensus on metric definitions; assists in setting realistic and achievable targets based on evidence and national benchmarks.
6. Develops key clinical quality indicators and measurement strategies, including analyzing and interpreting technical measurement specifications, collaborating with clinical and technical stakeholders and validating results.
7. Creates queries, standard reports, dashboards and recommendations for new solutions and analyze existing reports and interfaces, traces metrics to data sources and defines the logic used to create the metrics.
8. Designs, interprets and presents data in formats such as data visualizations, dashboards, and reports; consolidates information from databases, business intelligence tools and other applicable software and presents actionable findings to operational and clinical leaders.
9. Performs other duties as assigned.
MINIMUM QUALIFICATIONS:
Any combination of education and experience that would likely provide the required knowledge, skills and abilities as well as possession of any required licenses or certifications is qualifying.
Required Education : Bachelor's degree in Business Administration, Health Care Administration, Public Health, Statistics or other health related field. Preferred Education : Master’s degree in related field.
Required Experience : Three years experience in a process and quality improvement role within a health care related environment (acceptable experience to include interships/volunteer work).
Quality
Quality Analytics
Full Time
Day
Business Professional & IT
FTE: 1