Current jobs related to Clinical Quality Analytics, Senior - Long Beach CA United States - Blue Shield of California
-
Clinical Quality Analytics, Senior
2 weeks ago
Long Beach, CA, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Senior
1 month ago
Long Beach, CA, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior...
-
Clinical Quality Analytics, Senior
2 weeks ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Senior
1 month ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Senior
2 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Senior
3 months ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Senior
1 week ago
Long Beach, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Senior
3 months ago
United States, CA, Long Beach, 90802 Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Senior Claims Quality
2 weeks ago
Long Beach, CA, United States Blue Shield of California Full timeYour Role The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will...
-
Clinical Quality Analytics, Consultant
3 months ago
United States, CA, Oakland Blue Shield of California Full timeYour Role The Clinical Quality Measurement team manages HEDIS annual submissions and other quality measure submissions to CMS, NCQA, DHCS and other governing bodies. The Medical Informatics Analyst, Consultant will report to the Sr Manager, Medical Informatics. In this role You will support corporate and departmental strategies and goals for the annual HEDIS...
-
Clinical Quality Analytics, Consultant
2 months ago
Oakland, CA, United States Blue Shield of California Full timeYour Role The Clinical Quality Measurement team manages HEDIS annual submissions and other quality measure submissions to CMS, NCQA, DHCS and other governing bodies. The Medical Informatics Analyst, Consultant will report to the Sr Manager, Medical Informatics. In this role You will support corporate and departmental strategies and goals for the annual HEDIS...
-
Clinical Quality Analytics, Consultant
2 weeks ago
Oakland, CA, United States Blue Shield of California Full timeYour Role The Clinical Quality Measurement team manages HEDIS annual submissions and other quality measure submissions to CMS, NCQA, DHCS and other governing bodies. The Medical Informatics Analyst, Consultant will report to the Sr Manager, Medical Informatics. In this role You will support corporate and departmental strategies and goals for the annual...
-
Clinical Quality Consultant
5 days ago
Merced, CA, United States Clinical Management Consultants Full timeA leading acute care hospital located in Central California is now searching for an experienced Clinical Quality Consultant to join their award-winning healthcare team. Reporting to the Director of Quality, the Nurse Coordinator Quality Assurance will monitor and improve inpatient and outpatient medical record documentation, ensures compliance with all state...
-
Manager, Pharmacy Analytics
2 months ago
Long Beach, United States SCAN Full timeAbout SCAN SCAN Group is a not-for-profit organization dedicated to tackling the most pressing issues facing older adults in the United States. SCAN Group is the sole corporate member of SCAN Health Plan, one of the nation’s leading not-for-profit Medicare Advantage plans, serving more than 270,000 members in California, Arizona, Nevada, Texas and New...
-
Orlando, FL, United States Clinical Management Consultants Full timeAre you a visionary leader with a passion for elevating patient care standards? Imagine stepping into a pivotal role where your expertise in quality, infection control, and patient safety will shape the future of healthcare. Our client, a highly reputable hospital nestled in the heart of Coastal Florida, is on the hunt for an extraordinary Hospital Senior...
-
Senior Health Clinical Strategist
10 hours ago
Long Beach, California, United States ACCS - ARES Customer Care Solutions GmbH Full timeAbout the RoleWe are seeking a highly skilled Medical Director to join our Senior Health team in a National role. The successful candidate will be responsible for guiding the clinical management of our patients across markets, with a focus on Geriatrics and value-based care performance.Key ResponsibilitiesAccountable for Part B performance, including PMPM...
-
Pharmacy Analytics Manager
3 days ago
Long Beach, California, United States SCAN Full timeJob Title: Pharmacy Analytics Manager**About SCAN**SCAN Group is a leading not-for-profit organization dedicated to addressing the most pressing issues facing older adults in the United States. As a pioneering expert in senior healthcare, we are committed to keeping seniors healthy and independent.**Our Mission**We serve over 270,000 members in California,...
-
Mgr, Clinical Analytics
1 month ago
United States Magellan Health Full timeManages primary data and analytics support for assigned business unit, working closely with national and local leadership to drive clinical analytics relative to risk adjustment (Medicare HCC, Medicaid CDPS-Rx), Quality (HEDIS/STARS), risk stratification and population health initiatives. Provides subject matter expertise on statistical techniques, data...
-
Clinical Quality Consultant
3 weeks ago
Merced, CA, United States Clinical Management Consultants Full timeA leading acute care hospital located in Central California is now searching for an experienced Clinical Quality Consultant to join their award-winning healthcare team.Reporting to the Director of Quality, the Nurse Coordinator Quality Assurance will monitor and improve inpatient and outpatient medical record documentation, ensures compliance with all state...
-
Senior Software Engineer
11 hours ago
Long Beach, California, United States Department of Energy, Environment and Climate Action Full timeAbout the RoleWe are seeking a highly skilled Senior Software Engineer to join our Data Analytics and Information Systems (DAIS) team at the Department of Energy, Environment and Climate Action. As a key member of our team, you will play a critical role in designing, developing, and delivering complex data systems that enable us to plan, monitor, and respond...
![Blue Shield of California](https://media.trabajo.org/img/noimg.jpg)
Clinical Quality Analytics, Senior
2 months ago
Your Role
The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Senior will report to the Clinical Quality Manager or Senior Manager. In this role you will provide data, analytic and reporting support for the Clinical Quality Department to improve Blue Shield of California and Promise Health Plan quality performance for regulatory and accreditation requirements including National Committee for Quality Assurance, Centers for Medicare and Medicaid and Department Health Care Service.
Your Work
In this role, you will:
- Conduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reports
- Develop documentation and create and execute workplans for analyses of high complexity
- Produce analysis of high complexity under the guidance and direction of Clinical Quality Analyst – Consultant or Principal or Manager
- Design, build, and enhance data systems and applications so that they better serve specific reporting requirements
- Identify business risks relating to report design and production
- Collect data from various internal systems (example Claims processing or membership systems) and external systems (EMR/EHR) and converts those data to actionable insights to guide business decision making for BSC populations' health management and quality of care
- Produce monthly provider and/or employer group specific reports based on HEDIS measures in alignment with reporting quality ratings systems such as NCQA Stars/Accreditation, Medicare Stars, Medi-Cal Managed Care Accountability Sets, Quality Transformation Initiative and Quality Rating System
- Partner with the HEDIS data team, Clinical Quality Analytics and Medical Record Review teams to support HEDIS performance improvement initiatives
Your Knowledge and Experience
- Requires a bachelor’s degree in health science, quantitative social science, public health, health services research or business or equivalent experience
- Prefer an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research or business
- Requires at least 2 years of SAS/SQL programming experience
- Requires at least 5 years of prior operational and / or data analysis experience, experience in database structures, and standard query and reporting tools
- Proficient in MS Office – Word, Excel and Powerpoint
- Requires at least 2 years of programming using inpatient claims, outpatient encounters, membership, pharmacy or laboratory data.
- Requires at least 2 years of experience with ICD (International Classification of Diseases) codes, CPT (Current Procedural Terminology) codes, Diagnostic Related Group (APR-DRG/MS-DRG) codes or Healthcare Common Procedure Coding System (HCPCS) codes
- Requires at least 3 years of experience in Health Care (managed care, academic, or gov't payer)
- Requires at least 1 year of experience working with NCQA HEDIS quality measures
- Requires at least 1 year of experience with NCQA Health Plan Rating, CMS Medicare Advantage Star Rating or Medi-Cal Managed Care Accountability Sets (MCAS)
- Preferred experience with visual management (eg. Tableau, Power BI) or task management tools (eg. JIRA, Work Front, Sharepoint) or cloud data (eg. Azure, AWS, Snowflake)
- Preferred- Mastery of at least two of the following: clinical coding, large-scale health databases, health statistics (e.g., epidemiology or health services), health insurance business principles. Must have sufficient familiarity with the technical and clinical concepts necessary to adequately perform the duties described above.
- Experience developing SAS/SQL programs and scripts that can be passed on to other analysts to improve their work efficiency.
- Must be able to develop programs and scripts that can be used to repeatedly to generate reliable reports and analytics
- Strong verbal and written communication skills
- Must exhibit level-appropriate competence in Departmental competency dimensions (Communication, Agile Learning, Business Knowledge, Creativity, Critical Thinking, Customer Focus, Drive for Results).
- Capable of managing deadlines and working simultaneously on a variety of tasks
- Experience with cost-of-healthcare or quality of care assessment in a managed care or academic setting
- Experience utilizing a certified HEDIS software.
Pay Range:
The pay range for this role is: $ 99000.00 to $ 148500.00 for California.
Note:
Please note that this range represents the pay range for this and many other positions at Blue Shield that fall into this pay grade. Blue Shield salaries are based on a variety of factors, including the candidate's experience, location (California, Bay area, or outside California), and current employee salaries for similar roles.
#LI-MM4