Performance Improvement Analyst

Affinity Health Plan, an independent, growing, not-for-profit managed care company designed specifically to serve the needs of low-income New Yorkers, needs a Performance Improvement Analyst for its Systems Integration Department. Under the direction of the Manager of Affinity’s Quality Measurement, Analysis and Reporting Unit, the Analyst is responsible for analyzing information, interpreting Quality Management data needs, and collaborating on establishing data quality specifications with MIS/Operations and the unit’s Senior Programmer; designing, coordinating and supporting integrated data systems for, and analyzing all information pertaining to, the quality management function; and coordinating initiatives to improve data quality with providers and operations staff and integrating all data needs for the Plan. As part of your responsibilities, you will:

 

§ Design and build tailored relational databases for diverse QM-related data entities based on departmental needs, in collaboration with the Senior Programmer,.

§ Analyze and evaluate administrative and clinical data, and produce effective presentations and documents, making recommendations about methods and protocols to ensure effective, efficient quality improvement strategies for data processing/management.

§ Produce reports according to specifications, utilizing data warehouses to create membership and utilization tables and review patterns of utilization; drafting method guides for provider data reports.

§ Interpret and analyze clinical study data submitted by providers and/or entered by QM staff, and quantify into formats for standardization and reporting.

§ Collaborate with internal/external customers to facilitate continual quality improvement in submission and processing of accurate, complete and timely data that meets internal and external customer needs.

§ Run reports of all targeted activities, produce tracking and trending reports of progress on all projects; prepare summaries for meetings; present data reports as required and produce educational documents for providers around technical issues

§ Participate in the organization, coordination and implementation of performance improvement activities, including HEDISQARR projects, as assigned.

§ Support data management needs for the Quality Measurement Analysis and Reporting Unit activities, including HEDISQARR, MEDSII, CMS studies, credentialing, etc.

§ Perform other duties as necessary or assigned.

 

 

Requirements for this position include:

 

§ BA/BS, preferably with data management and/or statistical emphasis

§ 2-4 years experience developing relational database systems in Windows

§ Programming expertise with dBase, FoxPro, Paradox, Access, Visual Basic and Excel

§ Proficiency with SAS and/or SPSS preferred, but not required

§ Strong analytical, organizational and data manipulation/management skills

§ Knowledge of medical/insurance terminology, coding and delivery of health service practices

§ Knowledge of health plan operations and Medicaid managed care

§ Technical writing, editing, and research statistics experience preferred

§ Demonstrated ability to prepare effective presentations and layouts

§ Expert level proficiency with Microsoft Office applications including Word, Excel and Access; familiarity with Facets or other business system preferred

§ Excellent verbal/written communication skills to ensure effective and precise communication of information, requests, etc.

§ Effective interpersonal skills characterized by diplomacy to foster effective collaboration

§ Process improvement experience or knowledge of quality improvement methodologies preferred.

 

If you meet these qualifications and are interested in this position, please respond through our website, http://www.affinityplan.org under Careers/Open Positions on the main page. You can also fax your resume to 718-794-7846, stating that you are applying for this position on the fax cover sheet. We are an Equal Opportunity/AA Employer. Only qualified applicants will receive a response.