Program Evaluation Specialist

4 months ago


Smithfield, United States Neighborhood Health Plan of Rhode Island Full time

The Program Evaluation Specialist sits within the Analytics function, where organizational intelligence, data analysis, and insights drive evidence-based decision making. This position is responsible for leading program evaluation efforts through: data-driven program design; literature reviews of evidence-based best practices and anticipated quality outcomes; program evaluation design; evaluation data analysis; and written and oral presentation of evaluation findings. This position supports the program development and assessment needs of the Medical Management division Care Management, Disease Management, Behavioral Health, and Population Health Management), the Accountable Entity program, the Quality and Improvement department, and other intervention and innovation efforts of internal business partners.

The Program Evaluation Specialist works both independently and collaboratively, pulling together and analyzing complex data and information to provide meaningful results, identify success factors and improvement opportunities, suggest potential solutions, and help internal customers set strategic directions.

The incumbent Program Evaluation Specialist should bring intellectual curiosity, proven data analytics skills, and a spirit of creativity and problem-solving to deepen insights into the factors that drive health care quality, costs, and equity. This role requires a solid understanding of program evaluation and quality measurement, intermediate SAS and/or SQL technical skills, and ability to collaborate and communicate with business areas throughout the organization. In this position, passion and skills come together to better serve our members and community.

Duties and Responsibilities

Responsibilities include, but are not limited to the following:

Responsible for conducting all phases of program evaluations, including creating analysis plans and timelines, data collection, data analysis, and communications and reporting. Design and implementation of care and disease management program evaluations Develop analyses of program, cost, and quality metrics for internal review, intervention development, and external reporting Support the Population Health Management team in data-driven intervention development, key performance indicator selection and monitoring, and full program evaluations. Work closely with other departments to build analytical approaches to evaluate health outcomes, economic impact, and disparity gap closure of clinical and population health programs. Analyze data and create materials to communicate findings to a variety of stakeholders Conduct literature reviews and research to support program improvements Participate in team and internal committee meetings Develop and monitor key performance indicators and metrics to measure the success and cost effectiveness of managed care programs Collaborates with partners from the Analytics department and other teams to assess interventions as part of NCQA annual reporting Other duties as assigned Corporate Compliance Responsibility - As an essential function, responsible for complying with Neighborhood’s Corporate Compliance Program, Standards of Business Conduct, applicable contracts, laws, rules and regulations, policies and procedures as it applies to individual job duties, the department, and the Company. This position must exercise due diligence to prevent, detect and report unlawful and/or unethical conduct by fellow co-workers, professional affiliates and/or agents

Pay Grade- G

Range- Min. $62K, Mid. $81k, Max. 100k



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