Data and Reporting Analyst Lead

3 weeks ago

Orange, United States CalOptima Full time

**Data and Reporting Analyst Lead**

**CalOptima**

**CalOptima Health** is seeking a highly motivated an experienced **Data and Reporting Analyst - Lead** to join our team. The Data and Reporting Analyst - Lead (HEDIS) will be responsible for developing and maintaining Healthcare Effectiveness Data and Information Set (HEDIS) data reports to support the regulatory requirements from the Centers for Medicare & Medicaid Services (CMS), National Committee for Quality Assurance (NCQA) and California Department of Healthcare Services (DHCS). The incumbent will be responsible for continually improving data acquisition, enhancing data processing, assurance on data reporting and providing data analysis. The incumbent will provide expertise in business requirements and train other Analysts for the HEDIS data system in the Quality Analytics department.

**Position Information**:

- Department**:Quality Analytics**:

- Salary Grade**:M - $85,000 - $141,089**:

- Work Arrangement**:Full Telework**

**This position is eligible for telework in California.***

**Duties & Responsibilities**:

- 80% - Data and Reporting Support
- Maps multiple internal data sources (e.g., claims, encounters, pharmacy, providers, enrollment, lab, etc.) and external data sources (registry, electronic medical record (EMR), etc.) for HEDIS reporting.
- Ensures data integrity from the data warehouse and HEDIS software.
- Researches data integrity issues and provides solutions.
- Provides expertise in HEDIS data analysis, including member, provider, claims and encounters.
- Maintains a thorough knowledge of HEDIS reporting specifications, DHCS specific reporting requirements and CMS data reporting requirements.
- Writes detailed Scope of Design documents for HEDIS data processing and auditing.
- Conducts quality assurance on data loaded into the HEDIS software, reviews results for accuracy and prepares for annual HEDIS compliance audits.
- Maintains a thorough knowledge of CalOptima Health's data, provides feedback to Information Technology Services (ITS) to resolve data integrity issues and to support reporting requirements.
- Prepares ad-hoc analyses and works on special projects.
- Reviews proposed HEDIS measure requirements and implements changes for plan level or program-specific reporting as requested. Provides technical support for HEDIS hybrid sampling, medical records retrieval and reviewing.- 15% - Program Support
- Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
- Provides guidance and training on HEDIS repository to the other Data Analysts within the department.
- Acts as the point of contact for data requests, assigns requests to other Data Analysts as appropriate and monitors timeliness and outcomes. Assists the team in carrying out department responsibilities and collaborates with others to support short
- and long-term goals/priorities for the department.- 5%
- Completes other projects and duties as assigned.

**Minimum Qualifications**:

- Bachelor's degree in healthcare administration, public health or related field required.
- 5 years of HEDIS reporting experience required.
- 3 years of Microsoft Access/Structured Query Language (SQL) experience required.
- 3 years of experience in a managed care or health care organization required.
- Health care data reporting and analysis experience required.
- An equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.

**Preferred Qualifications**:

- Master's degree in public health, informatics or related field.
- Experience with HEDIS software.

**Required Licensure / Certifications**:

- N/A

**Knowledge & Abilities**:

- Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
- Work independently and exercise sound judgment.
- Communicate clearly and concisely, both orally and in writing.
- Work a flexible schedule; available to participate in evening and weekend events.
- Organize, be analytical, problem-solve and possess project management skills.
- Work in a fast-paced environment and in an efficient manner.
- Manage multiple projects and identify opportunities for internal and external collaboration.
- Motivate and lead multi-program teams and external committees/coalitions.

**Physical Requirements (With or Without Accommodations)**:

- Ability to visually read information from computer screens, forms and other printed materials and information.
- Ability to speak (enunciate) clearly in conversation and general communication.
- Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
- Manual dexterity for typing, writing, standing and reaching, flexibility, body m

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