Manager, Clinical Quality Analytics
Company: L.A. Care Health Plan
Location: Los Angeles
Posted on: November 19, 2024
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Job Description:
Manager, Clinical Quality Analytics Job Category: - Clinical
Department: - Quality Improvement Location: Los Angeles, CA, US,
90017 Position Type: Full Time Requisition ID: 11561 Salary Range:
- -$117,509.00 -(Min.) - -$152,762.00 -(Mid.) - -$188,015.00
-(Max.)Established in 1997, L.A. Care Health Plan is an independent
public agency created by the state of California to provide health
coverage to low-income Los Angeles County residents. We are the
nation's largest publicly operated health plan. Serving more than 2
million members, we make sure our members get the right care at the
right place at the right time.Mission: L.A. Care's mission is to
provide access to quality health care for Los Angeles County's
vulnerable and low-income communities and residents and to support
the safety net required to achieve that purpose. - The Manager of
Clinical Quality Analytics (MSA) is responsible for the operations,
projects and planning of the reporting and analytics on quality
programs for all of L.A. Care's line of business (LOB) which
includes Medicare Stars, Exchange Quality Rating Systems and
MediCal's Managed Care Accountability Sets, and other data-sharing
and/or quality improvement programs focused on enhancing member
experience and quality of life. The MCQA is responsible for
analyzing, monitoring, reporting, and providing technical
collaboration and data driven decision making on clinical and
operational quality improvement activities related to these
programs. The MCQA recommends policies, and leads process
improvement efforts. Additionally, the MCQA works with the Quality
Improvement team, department leadership, and the provider network
on developing plan-wide quality improvement and data strategy
activities. The MCQA assists in developing a long-term plan for
analytics and evaluation activities to support the quality
improvement strategy and goals, including enterprise wide data and
analytics solutions. The MCQA manages all aspects of running an
efficient team, including hiring, supervising, coaching, training,
disciplining, and motivating direct and indirect staff reports.
Duties Leverage data to inform targeted strategies that indicate
whom to engage, with what content and through which channel and
frequency: prioritize members and providers based on
characteristics, such as RAF scores, open care gaps and quality
improvement performance to enable a targeted and tailored outreach
for members and providers through preferred channels - web, print,
email, etc. Implement a data-driven quality improvement strategy
and predictive model to prioritize a set of measures that will
drive higher quality ratings. Evaluate measures on a regular
schedule to accommodate quality improvement performance changes
throughout the year. These insights will enable accountable
entities to make in-flight adjustments as needed, throughout the
measurement year. Establish streamlined and accurate process for
quality improvement performance scorecards at the contract,
provider and member level along with predictive analytics models.
Work closely with QPM, HIM and other analytics teams and vendors to
ensure provider web based quality tools used to monitor performance
and close diagnosis and care gaps are complete, accurate, and
timely and provide actionable insights at the member level. Develop
meaningful dashboards, reports, tools, and presentations to inform
and influence Stars strategy and related activities. Act as an
analytics and technical subject matter expert on teams working on
development and execution of Stars strategic initiatives. Work
closely with Quality Improvement team to manage and lead quality
reporting and analytical strategies to enable accountable entities
and stakeholders to drive quality ratings improvement for CAHPS,
HOS, HEDIS, Medication Adherence and Plan Operations Manage staff,
including, but not limited to: monitoring of day to day activities
of staff, monitoring of staff performance, mentoring, training, and
cross-training of staff, handling of questions or issues, etc.
raised by staff, encourage staff to provide recommendations for
relevant process and systems enhancements, among others. Perform
other duties as assigned. Education Required Bachelor's Degree in
Business or Related Field In lieu of degree, equivalent education
and/or experience may be considered. Education Preferred Master's
Degree in Public Health or Health Informatics ExperienceRequired:
At least 6 years of experience in HEDIS, quality improvement, risk
adjustment analytics, research, or related work within a healthcare
context. At least 4 years leading staff or supervisory/management
experience. Experience working with complex data sets. Experience
with developing reports in Tableau, SQL and developing datasets and
data marts. - Equivalency: Completion of the L.A. Care Management
Certificate Training Program may substitute for the
supervisory/management experience requirement. Skills Required:
Ability to effectively collaborate and support cross functional
department leadership. Strong understanding of health care quality
reporting programs, specifically Medicare Stars and HEDIS and
health plan regulatory reporting requirements. High degree of
initiative and motivation. Strong understanding of best practices
in data visualization including Tableau Strong understanding of
value-based payment concepts and related engagement strategies.
Knowledge of SQL coding. Knowledge of managed care concepts and
principles and basic health plan operations. Excellent analytical,
problem solving and decision-making skills. Ability to manage
multiple tasks and projects and to delegate. Excellent reading,
oral and written communication and interpersonal skills. Ability to
work independently. Licenses/Certifications
RequiredLicenses/Certifications PreferredRequired TrainingPhysical
Requirements Light Additional InformationSalary Range Disclaimer:
The expected pay range is based on many factors such as geography,
experience, education, and the market. The range is subject to
change.L.A. Care offers -a wide range of benefits including
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Keywords: L.A. Care Health Plan, Santa Barbara , Manager, Clinical Quality Analytics, Executive , Los Angeles, California
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