Healthcare Quality Analyst I
Tucker, USA IT development
Job description
· Job Description:
Establishes and reports Key Performance Indicators (KPI) Performs quality analysis, inspects, root cause analysis. Establishes Key Performance Indicators (KPIs) and reporting based on the needs of business to support strategy and overall directional improvement. Understand and validate data integrity in data and reporting systems while supporting established quality standards, performing quality analyses, inspections and root cause analysis. Conduct programs to establish process requirements, design, mapping and evaluation. Review and monitor the effectiveness of various processes through the retrieval and analysis of data. Identifies and evaluates opportunities, risk, deficiencies while working with internal departments/business units to deliver the appropriate remedies and subsequently test, track and verify the solutions. Create and deliver relevant ongoing communications and metric scorecards to respective management, program teams and business teams.
Responsibilities:
o Monitoring quality performance indicators, tools and processes for data collection, analysis and reporting for quality management and continuous improvement of business unit including call center interactions, metrics, claims review and operational deliverables.
o Collects, consolidates, and charts data from testing and process results for assigned portions of product and solution areas to identify trends and issues; learns and practices basic root- cause analysis.
o Implements specified changes to quality processes to reduce defects and improve quality.
o Develops understanding of and relationship with stakeholders for product and process quality.
Education and Experience Required:
o High School diploma and three (3) years Medicaid or health care quality assurance support experience
Knowledge and Skills:
o Experience or understanding of data collection and analysis tools.
o Good analytical, statistical and problem solving skills.
o Basic understanding of healthcare industry and internal quality standards and methodologies.
o Good written and verbal communication skills.