Clinical Quality Analytics, Consultant
1 week ago
Your Role
The Clinical Quality Analytics 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 - Consultant will report to the Clinical Quality Analytic Senior Manager under the day-to-day supervision of the Clinical Quality Analytics - Principal, Medicare Lead. 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 - Medicare quality performance for regulatory and accreditation requirements including National Committee for Quality Assurance, Centers for Medicare and Medicaid and Department Health Care Service.
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 5 years of SAS/SQL programming experience
- Requires at least 7 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
- Experience with visual management tools (eg. Tableau, Power BI) or task management tools (eg. JIRA, Work Front, Sharepoint) or cloud data (eg. Azure, AWS, Snowflake)
-
Experience working with RDBMS: Oracle, Netezza, DB2 etc.
Requires at least 5 years of programming using inpatient claims, outpatient encounters, membership, pharmacy or laboratory data.
Requires at least 5 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 5 years of experience in Health Care (managed care, academic, or gov't payer)
Requires at least 3 years of experience working with NCQA HEDIS quality measures
Experience utilizing certified HEDIS software
Requires at least 3 years of experience with NCQA Health Plan Rating, CMS Medicare Advantage Star Rating or Medi-Cal Managed Care Accountability Sets (MCAS)
-
Clinical Quality Analytics, Consultant
1 week ago
Los Angeles, CA, United States Blue Shield Of California Full timeJob DescriptionYour Role The Clinical Quality Analytics 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 - Consultant...
-
Stroke Coordinator-Quality
2 weeks ago
Los Angeles, CA, United States Kaiser Permanente Full timeJob Summary: Passionate about stroke care? Ready to inspire change at the bedside and beyond? Join us as our Stroke Coordinator and become a leader in advancing excellence for our patients and teams. In this role, you-ll mentor and educate bedside nurses, champion quality improvement initiatives, and grow alongside our Nursing Services. If you value...
-
Los Angeles, CA, United States Kaiser Permanente Full timeJob Summary: In addition to the responsibilities listed below, this position is also responsible for working collaboratively with statisticians and researchers to provide programming in analytical programming languages (may include SAS, SQL, SPSS, R, Python, etc.), data management, and quality control support for a wide variety of projects; maintaining a...
-
Quality Assurance Engineer
1 day ago
Los Angeles, CA, United States ShiftCode Analytics Full timeInterview : Video Visa : USC and GC This is hybrid from day-1 Description : MUST HAVE: US Citizen or Green Card Holders only Must be vaccinated for Covid-19 Must have experience working in healthcare domains - Membership Portals, Provider Portals, Claims (QNXT/Facets) and EDI Candidates should have SQL backend testing and performance testing for mobile...
-
Quality Assurance Engineer
1 week ago
Los Angeles, CA, United States ShiftCode Analytics Full timeInterview : Video Visa : USC and GC This is hybrid from day-1 Description : MUST HAVE: US Citizen or Green Card Holders only Must be vaccinated for Covid-19 Must have experience working in healthcare domains - Membership Portals, Provider Portals, Claims (QNXT/Facets) and EDI Candidates should have SQL backend testing and performance testing for mobile...
-
Quality Assurance Engineer
3 days ago
Los Angeles, CA, United States ShiftCode Analytics Full timeInterview : Video Visa : USC and GC This is hybrid from day-1 Description : MUST HAVE: US Citizen or Green Card Holders only Must be vaccinated for Covid-19 Must have experience working in healthcare domains - Membership Portals, Provider Portals, Claims (QNXT/Facets) and EDI Candidates should have SQL backend testing and performance testing for mobile...
-
Quality Assurance Engineer
2 weeks ago
Los Angeles, CA, United States ShiftCode Analytics Full timeInterview : Video Visa : USC and GC This is hybrid from day-1 Description : MUST HAVE: US Citizen or Green Card Holders only Must be vaccinated for Covid-19 Must have experience working in healthcare domains - Membership Portals, Provider Portals, Claims (QNXT/Facets) and EDI Candidates should have SQL backend testing and performance testing for mobile...
-
Clinical Consultant
7 days ago
Los Angeles, CA, United States Amity Foundation Full timeAmity Foundation, an internationally acclaimed Teaching, and Therapeutic Community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as an ECM Clinical Consultant (LA). This groundbreaking opportunity will allow you to work with our prison and re-entry programs helping the community and will also...
-
Clinical Consultant
1 week ago
Los Angeles, CA, United States Amity Foundation Full timeAmity Foundation, an internationally acclaimed Teaching, and Therapeutic Community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as an ECM Clinical Consultant (LA). This groundbreaking opportunity will allow you to work with our prison and re-entry programs helping the community and will also...
-
Clinical Consultant
1 day ago
Los Angeles, CA, United States Amity Foundation Full timeAmity Foundation, an internationally acclaimed Teaching, and Therapeutic Community is seeking compassionate and enthusiastic individuals with a desire to teach, learn and join our community as an ECM Clinical Consultant (LA). This groundbreaking opportunity will allow you to work with our prison and re-entry programs helping the community and will also...
