Clinical Quality Research Analyst
4 weeks ago
Work Location: 300 E. Randolph Street, Chicago, IL, 60601
Onsite, 8:00-4:30 CST
Contract: 2024-05-06 to 2024-12-31
Job Purpose:
This position is responsible for conducting data collection and abstraction of medical records for HEDIS and Quality projects including supplemental data collection. Responsible for interacting with various internal staff, internal departments, and network providers/IPAs to ensure quality performance and results for Blue Cross managed care products. Responsible for auditing all aspects of BCBSIL clinical quality improvement projects and evaluating PCP/MG/IPA compliance with BCBSIL clinical practice guidelines. Also responsible for data analysis, interaction with providers’ practices and IPAs to educate on HEDIS measures, gaps in care and quality programs. Translate data into actionable information and determine areas for improvements as well as help implement actions toward improvement and report results to internal and external customers.
Job Responsibilities:
- Interact with various internal departments, network practitioners, and MG/IPAs to ensure quality for Blue Cross and Blue Shield managed care products. Responsible for auditing, analysis of clinical data, and interaction with providers to translate data into information, determine areas for improvement, and help implement actions toward improvement.
- Conduct audits for HMO Clinical Quality Improvement Projects. Analyzes data and creates reports for statistically significant random samples regarding interrater reliability. Reports findings to project-specific workgroups and management. Identifies opportunities for improvement. Assists with implementation of corrective action plans. Re-audits to evaluate effectiveness of interventions.
- Develop reports and presents findings to QI, Workgroups, as well as the Managed Care Quality Improvement Committees regarding HMO, PPO/FEP and POS quality improvement issues.
- Perform quantitative and qualitative analysis for HMO and POS Clinical Quality Improvement projects. Creates detailed Quality Improvement Activity reports required for NCQA accreditation, evaluates outcomes, works with Quality Management Specialists to determine opportunities for improvement, and helps implement actions toward improvement. Documents actions taken for improvement and measures the impact of interventions to determine if changes or improvements are statistically significant.
- Conduct formal presentations, reporting results from oversight of delegated Behavioral Health continuity and coordination performance Medical Management audits, HMO Clinical Quality Improvement QI Fund Projects, and provider appeal data analysis at project specific, HEDIS and Quality Improvement Workgroups.
- Perform onsite and concurrent audits for HEDIS Effectiveness of Care clinical indicators during data abstraction process, evaluate interrater reliability through analysis of employee-specific results, reports results to staff and management, assists with re-training employees on areas with identified deficiencies and evaluating the effectiveness of re-training.
- Communicate and interact effectively and professionally with co-workers, management, customers, etc.
- Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
- Maintain complete confidentiality of company business.
- Maintain communication with management regarding developments within areas of assigned responsibilities and perform special projects as required or requested.
Required Job Qualifications:
- Registered Nurse (RN) OR licensed clinician with current, unrestricted license in Illinois
- Minimum of 3 years of clinical practice experience performing HEDIS medical record review
- Minimum of 3 years of Healthcare or Managed Care experience, including quality improvement and/or project management experience
- Minimum of 1-year HEDIS medical record data abstraction
- Data analysis experience, skills and knowledge of statistical analysis software, and statistical methods and meaning knowledge.
- Ability to adapt to changing priorities and managing a wide range of quality projects
- Able and willing to travel? Verbal and written communication skills
- Problem resolution skills and ability to work with difficult situations with respect and diplomacy.
- Presentation planning and delivery experience for provider training
Preferred Job Qualifications:
- Working knowledge of managed care programs and NCQA and/or URAC Accreditation guidelines
- Project management experience and skills
-
Clinical Quality Research Analyst
1 month ago
Chicago, United States Vanator Full time**Job Purpose**: This position is responsible for conducting data collection and abstraction of medical records for HEDIS and Quality projects including supplemental data collection. Responsible for interacting with various internal staff, internal departments, and network providers/IPA’s to ensure quality performance and results for Blue Cross managed...
-
Clinical Quality Research Analyst
3 weeks ago
Chicago, United States Innovative Systems Group Full timeWork Location: 300 E. Randolph Street, Chicago, IL, 60601Onsite, 8:00-4:30 CSTContract: 2024-05-06 to 2024-12-31Job Purpose:This position is responsible for conducting data collection and abstraction of medical records for HEDIS and Quality projects including supplemental data collection. Responsible for interacting with various internal staff, internal...
-
Research Analyst
4 weeks ago
Chicago, Illinois, United States William Blair Full timeWilliam Blair Investment Management is committed to building enduring relationships with our clients. We work closely with private and public pension funds, insurance companies, endowments, foundations, and sovereign wealth funds, as well as financial advisors. We are 100% active-employee-owned with broad-based ownership. Our investment teams are solely...
-
Clinical Research Regulatory
4 weeks ago
Chicago, United States Insight Hospital and Medical Center Full timeInsight Research Institute is a rapidly growing non profit organization looking to expand its clinical research division at the Insight Hospital and Medical Center in Chicago, IL. We are looking for driven, motivated, and experienced candidates who can spearhead operations in a fast-paced, high-growth environment and who represent our core values. Job...
-
Clinical Trial Research Nurse
4 weeks ago
Chicago, United States Alliance for Clinical Trial in Oncology Foundation Full timeJob DescriptionJob DescriptionThe Alliance for Clinical Trials in Oncology Foundation (Foundation) is a foundation created to enhance and expand the ability of the Alliance for Clinical Trials in Oncology (Alliance) to conduct cancer clinical research and address important treatment questions through large-scale clinical trials. Through efforts of the...
-
Clinical Trial Research Nurse
4 weeks ago
Chicago, Illinois, United States Alliance for Clinical Trial in Oncology Foundation Full timeThe Alliance for Clinical Trials in Oncology Foundation (Foundation) is a foundation created to enhance and expand the ability of the Alliance for Clinical Trials in Oncology (Alliance) to conduct cancer clinical research and address important treatment questions through large-scale clinical trials. Through efforts of the Foundation in support of the...
-
Program Evaluation Analyst, Clinical Outcomes
1 month ago
Chicago, United States ACGME Full timeJob DescriptionJob DescriptionJob Title: Program Evaluation Analyst, Clinical Outcomes Program Department: Department of Sponsoring Institutions and Clinical Learning Environment Programs FLSA Status: Exempt Reports to: Senior Director, Program Evaluation, CLER The following describes the various aspects of the designated job. Some or all of...
-
Program Evaluation Analyst, Clinical Outcomes
2 hours ago
Chicago, United States ACGME Full timeJob DescriptionJob DescriptionJob Title: Program Evaluation Analyst, Clinical Outcomes Program Department: Department of Sponsoring Institutions and Clinical Learning Environment Programs FLSA Status: Exempt Reports to: Senior Director, Program Evaluation, CLER The following describes the various aspects of the designated job. Some or all of...
-
CLINICAL TRIAL RESEARCH NURSE
2 weeks ago
Chicago, IL, USA, United States Alliance for Clinical Trial in Oncology Foundation Full timeThe Alliance for Clinical Trials in Oncology Foundation (Foundation) is a foundation created to enhance and expand the ability of the Alliance for Clinical Trials in Oncology (Alliance) to conduct cancer clinical research and address important treatment questions through large-scale clinical trials. Through efforts of the Foundation in support of the...
-
Clinical Research Coordinator
4 weeks ago
Chicago, United States Medix Full timePosition Overview: In this role you will ensure IRB approved protocols are implemented and followed; execute the informed consent process and monitor patient status and safety; collect and organize research data; schedule and conduct study-specific training and site in-services to study related staff on new or amended protocols, and educate patients and...
-
Chicago, United States RPM ReSearch Full timeJob DescriptionJob DescriptionSenior Manager Microbiology, Research, and Product DevelopmentThe Senior Manager Microbiology, Research has the ability to work in both existing and emerging topical anti-infective technologies and the ability to lead a microbiology group across other medical device applications. This role has responsibility for the scientific,...
-
Clinical Research Site Director
1 month ago
Chicago, United States M1 Health Full timeChicago Clinical Research Institute Job Title: Clinical Research Site DirectorJob Overview:The Clinical Research Site Director will be responsible for the overall operation and management of our clinical research site. This includes leading the development and implementation of the study protocols, recruiting and retaining study participants, and ensuring...
-
Clinical Research Site Director
4 weeks ago
Chicago, United States M1 Health Full timeChicago Clinical Research Institute Job Title: Clinical Research Site DirectorJob Overview:The Clinical Research Site Director will be responsible for the overall operation and management of our clinical research site. This includes leading the development and implementation of the study protocols, recruiting and retaining study participants, and ensuring...
-
Clinical Research Nurse
19 hours ago
Chicago, United States Fertility Centers of Illinois Full timeBe a part of a team dedicated to helping people build families! Fertility Centers of Illinois is one of the nation’s leading infertility treatment practices, providing advanced reproductive endocrinology services in the Chicagoland area for more than 30 years. FCI is now part of US Fertility! US Fertility is the largest physician-led partnership of...
-
Equity Research Analyst
1 month ago
Chicago, United States Kovitz Full timeThe Kovitz Core Equity Team utilizes a bottom-up, fundamental, research-driven security selection process and patient decision making to construct a concentrated portfolio of holdings. The analyst will work with senior investment team members to identify and research investment ideas in publicly listed U.S. companies across all market caps and...
-
Equity Research Analyst
1 month ago
Chicago, Illinois, United States Kovitz Full timeThe Kovitz Core Equity Team utilizes a bottom-up, fundamental, research-driven security selection process and patient decision making to construct a concentrated portfolio of holdings.The analyst will work with senior investment team members to identify and research investment ideas in publicly listed U.S. companies across all market caps and sectors. You...
-
Senior Investment Research Analyst
1 month ago
Chicago, Illinois, United States Morningstar Full timeJob Title: Senior Investment Research Analyst (multiple positions)Responsibilities:Develop clear opinions to support forward-looking ratings on funds and other investment vehicles based on research that focuses on the funds' management team, strategy, parent company, performance and expenses (20%).Conduct quantitative and qualitative analysis using our...
-
Clinical Research Associate
21 hours ago
Chicago, Illinois, United States Illinois Institute of Technology Full timeGeneral Description: Assists with various aspects of human clinical trials with supervision. Aspects of clinical trials include recruiting, screening, enrollment, scheduling subject visits, data entry, quality control, anthropometic measurements, study food preparation. Department: Institute of Food Safety and Health Position Category: Full Time ...
-
Research Internship
3 days ago
Chicago, United States Children's Research Triangle Full timeJob DescriptionJob DescriptionSalary: The CRT research team is offering part-time unpaid research internships to qualified undergraduates in the Chicago area. Most of the work is remote; however, interns are expected to come into the office at least once a week in order to help with tasks on site. The Spring cohort typically starts mid-January and goes...
-
Clinical Research Associate
6 days ago
Chicago, United States Northwestern University Full timeJoin our dynamic team at Northwestern University, a leading research institution dedicated to advancing public health through groundbreaking epidemiological research. We are committed to fostering a collaborative and innovative environment where talented individuals can thrive and make a meaningful impact on global health outcomes. The Department of...