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Quality Performance Senior Operational Analyst

2 months ago

Bakersfield, United States KHS Full time

We appreciate your interest in our organization and assure you that we are sincerely interested in your qualifications. A clear understanding of your background and work history will help us potentially place you in a position that meets your objectives and those of the organization. Qualified applicants are considered for positions without regard to race, color, religion, sex (including pregnancy, childbirth and breastfeeding, or any related medical conditions), national origin, ancestry, age, marital or veteran status, sexual orientation, gender identity, genetic information, gender expression, military status, or the presence of a non-job related medical condition or disability (mental or physical).

KHS reasonably expects to pay starting compensation for the position of Quality Performance Senior Operational Analyst in the range of $35.50 - $47.48 hourly.

Our Mission.. Kern Health Systems is dedicated to improving the health status of our members through an integrated managed health care delivery system.

General Purpose

The Senior Operational Analyst is responsible for providing operational department support for temporary or long-term processes, projects, or assignments Theyprovide data and reports using data query and self-service reporting tools for ongoing activities such as performance improvement projects.

The Senior Operational Analystis responsible for gaining departmental systems expertise through hands on experience and training within the department's operations. The position plays a central role in addressing various needs of the Quality Improvement Department, leveraging data analytics, with the ability to facilitate or govern operational discussions internally and externally to the department.

This position provides primary oversight, management and validation of data and reports submission for the annual Department of Health Care Services (DHCS) Managed Care Accountability Set (MCAS)/HEDIS audit. This includes serving as the liaison between the QI Department, vendors and internal KHS Department such as IT. They provide similar management and support for other department audits.

The Senior Operational Analyst may act as a subject matter expert for the QI Department regarding KHS' medical management platform and serves as department liaison to various technical and vendor resources.

Essential Duties and Responsibilities

General

  • Participate and contribute in the Agile and Project Management methodologies through planning to execution (i.e. requirements gathering; decomposition, development, etc.) in support of MCAS, department or corporate projects;
  • Demonstrates understanding of business software systems and manual processes to identify efficiencies for better performance and more accurate information;
  • Able to serve as mentor to others providing support and education on MCAS process analysis; core and peripheral technologies and systems; presentations, implementation processes and testing, etc;
  • Commitment and affinity for delivering the highest level of customer service to internal and external customers;
  • Exercises effective judgement and decision-making and keeps leadership appropriately informed;
  • Perform routine or operational processes or procedures in support the department's operational mission to the organization;


Technical
  • Exhibits advanced Microsoft Office Suite (Word, Excel, Power Point, Outlook, Visio, One Note) skills with experience creating presentations, templates, charts, pivot tables, formulas, and calculations;
  • Create simple Structured Query Language (SQL) statements in defined data structures for department specific analytics;
  • Applies understanding of the organization's current data structures and data extracting tools (Business Objects) for department analytics and processing. Understands the organization's current data structures and data extracting tools (Business Objects) for department analytics and processing;
  • Applies and maintains up-to-date expertise in Information Systems to support effective development and execution of projects and other data and reporting deliverables;
  • Elicits and clearly documents business and systems requirements;
  • Ability to analyze and synthesize business requirements, including recognizing patterns and conceptualizing processes;
  • Serve as a liaison between Operations and IT to assist or gather business requirements needed for data, reporting, system modifications, enhancement, and implementations;


Analysis
  • Effectively understands the influence of data created or used by a department on operations to identify operational efficiencies. Collaboratively work with department management to deconstruct high-level information into details and abstract up from the low-level information into generalized results;
  • Provides answers to operational questions and includes analytics to support business processes that contribute to the success of the department;
  • Leads or supports the implementation of business solutions by:
    • building relationships and partnerships with key stakeholders,
    • identifying business requirements,
    • evaluating necessary processes and workflows,
    • monitoring progress and results,
    • routinely identifies improvement opportunities, and
    • appropriately evaluates and prioritizes competing demands.
  • Collaborates appropriately with MCAS software vendor to implement requirements as outlined by HSAG and DHCS;


Communications
  • Provides necessary updates to the MCAS team on changes or updates to the MCAS software;
  • Remains up to date with department needs and strategies effectively utilizing communication methods to keep department staff and management updated;
  • Facilitates MCAS presentations to all types of diverse audiences (i.e. senior management or technical staff). Lead or participate in multiple projects by completing and updating project data with applicable analytics, adjusting schedules while determining daily priorities. Ensures efficient and on-time delivery of project tasks, adheres to proper escalation paths while managing vendor relationships. Validates MCAS software release implementations for data and report accuracy prior to submission to NCQA and State agencies;
  • During data and report validation of the MCAS audit, identifies issues and errors and submits tickets to resolve those items. Also tracks identified issues to resolution;
  • Create and maintain MCAS issue logs, meeting schedules, project summaries and updates.
  • Support system conversions, upgrades, and enhancements;
Education and Experience

Master's degree in Business, Statistics, Mathematics, or other related field with academic demonstration of analytical skills from an accredited school or equivalent; AND three (3) years' working experience with a Managed Care Organization (MCO) or similar type organization.

Other: Possession of valid driver's license and proof of State required auto liability insurance.

Up to 20% driving required.

We are an equal opportunity employer, dedicated to a policy of non-discrimination in employment on any basis.

Other details
  • Pay Type Hourly
  • Min Hiring Rate $35.50
  • Max Hiring Rate $47.48
  • Travel Required Yes
  • Travel % 20
  • Required Education Master's Degree


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