HEALTH CARE ANALYST, Performance Improvement Projects (PIPs)
SUMMARY
Under direction, conducts or validates quality/performance improvement projects for Medicaid Medical and/or Behavioral Health Managed Care Organizations (MCOs).
ESSENTIAL COMPETENCIES, DUTIES AND RESPONSIBILITIES
• Reviews and evaluates health care quality/performance improvement projects and provides input for continued improvement.
• Assists as a technical resource for the analysis of quality/performance improvement projects.
• Coordinates health care quality improvement studies projects.
• Provides technical assistance to States and MCOs in the design, implementation, analysis, evaluation, and reporting of health care quality improvement projects.
• Provides assistance to State and MCO representatives on the proper analytic quality improvement tools to be used in analyzing data and evaluating outcomes of quality improvement projects.
• Provide technical assistance to States and MCO representatives in the areas of scientific soundness of study design and interpretation of results, including but not limited to, sampling and statistical testing.
• Facilitates the assessment of causes/barriers to quality improvement.
• Translate the reviews and evaluations into written validation reports.
• Participates on conference calls with State and health plan representatives to interpret findings and share interpretation of quality/performance improvement projects.
• Work on multiple projects in a collaborative team environment.
• Ability to organize projects and meet project deliverable timelines.
EDUCATION AND/OR EXPERIENCE
• Bachelor's degree in a statistics, mathematics, epidemiology, public health or health-care related field preferred or an equivalent combination of education and statistics or mathematics experience. Master's degree preferred.
• Quality improvement and analytic experience preferred.
OTHER QUALIFICATIONS
• Health plan experience and/or familiarity with performance measures, such as HEDIS®, is desired. Ability to obtain certified professional in health care quality (CPHQ) after hire is desired.
• Comprehensive knowledge in statistics, research design, methodology, and data analysis. Knowledge of MS Office applications in a Windows environment.
• Familiarity with Windows environment.
• Excellent oral and written communication and interpersonal skills.
ACCOUNTABILITY
The PIP Analyst is accountable for the timeliness, completeness, accuracy, and quality of all assigned analytic functions and tasks.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
DISCLAIMER
This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs or technological developments).
Health Services Advisory Group, Inc.
3133 E. Camelback Rd., Suite 300
Phoenix, AZ 85016
Visit us on the web: www.hsag.com and through www.careerbuilder.com
Posted 5/14/2013
Performance Improvement Project (PIP) Manager
SUMMARY
Under limited direction, conducts or validates quality/performance improvement projects for Managed Care Plans (MCPs). With little edit, compiles the results and drafts portions of final reports. Oversees the clinical PIP review staff and interfaces with the RAT.
ESSENTIAL COMPETENCIES, DUTIES AND RESPONSIBILITIES
• Leads and directs quality improvement activities related to Medicaid.
• Evaluates performance improvement projects (PIPs) and provides technical guidance to Medicaid Health Plans.
• Oversees performance improvement project design, implementation strategies, and the attainment of quality outcomes.
• Identifies opportunities to improve the validation process and implements improvement structures to support activities.
• Identifies opportunities to improve internal processes and implements methods for improvement.
• Provides research leadership and analytical expertise for quality improvement projects.
• Responsible for the scientific soundness of study design, analysis and interpretation of a variety of health care studies.
• Conducts literature reviews and consolidates the findings and reports to the targeted audience.
• Serves as a subject matter expertfor the design and implementation of quality performance improvement studies.
• Proficient in the design, interpretation of findings, and reporting of health care performance improvement project.
• Knowledgeable with use of and implementation of causal/barrier process and tools.
• Determines appropriate interventions to improve managed care organization's performance.
• Coordinates quality improvement activities over several states.
• Proficient in training state and MCO representatives on performance improvement processes and tools.
• Orients, trains, and educate new staff.
• Meet with PIP review staff to support and assist with projects.
EDUCATION AND/OR EXPERIENCE
Master's degree in a health care-related field or an equivalent combination of education and clinical experience.
OTHER QUALIFICATIONS
• Certified Professional in Healthcare Quality (CPHQ) preferred.
• Experience in facilitating small and large groups of people with a common goal of improving performance in a defined area.
• Minimum of five years of quality improvement experience.
• Quality review and analytical experience preferred.
• Familiarity with Windows environment.
• Excellent oral and written communication and interpersonal skills.
WORK ENVIRONMENT
The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
DISCLAIMER
This is not necessarily an exhaustive list of all responsibilities, skills, duties, requirements, efforts or working conditions associated with the position. While this is intended to be an accurate reflection of the current position, management reserves the right to revise the position or to require that other or different tasks be performed when circumstances change (e.g., emergencies, changes in personnel, work load, rush jobs or technological developments).
Health Services Advisory Group, Inc.
3133 E. Camelback Rd., Suite 300
Phoenix, AZ 85016
Visit us on the web: www.hsag.com and through www.careerbuilder.com
Posted 5/14/2013 |
