Quality Systems Analyst I

Company: Inland Empire Health Plans
Location: Rancho Cucamonga
Posted on: September 21, 2023

Job Description:

Job Requisition ID: 9914 Position Summary/Position Under the direction of the Quality Systems Leadership Team, the Quality Systems Analyst I (QS Analyst) supports analytical studies and reports for the Health Plan Clinical and Provider departments, programs, and quality activities. The QS Analyst I is responsible for modeling healthcare related problems, discovering insights and identifying opportunities through the use of statistical, algorithmic, data mining, analysis and data visualization techniques. In addition to advanced analytical skills, the QS Analyst I will display proficiency at integrating and preparing varied datasets, architecting analytical databases and visualization environments, and communicating results that are compliant with IEHP business rules and reporting requirements. Responsible for managing assigned reporting projects to ensure that data and analysis requests are completed timely, accurately while presented in a way that meets the needs of the requesting department. The QS Analyst I must be able to assess requests and solicit feedback from requestors regarding any critical decision points that are necessary to complete requests accurately and timely. To do this effectively, the QS Analyst I must have knowledge of the various data sources available for reporting and must have a clear understanding of IEHP business operations in order to appropriately apply criteria and methodology to meet requestors' needs. The QS Analyst I must demonstrate effective communication skills with Team Members at all levels within the organization. It is also necessary to understand how Quality Systems deliverables - including standard reports, ad-hoc requests, studies, analyses, and recommendations - can impact business operations at IEHP.Major Functions (Duties and Responsibilities) 1.Development and design of reports and analyses to support IEHP's Medical Services departments needs utilizing available tools, including but not limited to: Microsoft applications - MS Access, SSRS, SAS, SPSS, Tableau, Crystal Reports, ArcGIS, system-specific reporting tools, or other related reporting software.2.Responsible for analyzing report requests to determine users' needs and objectives, working with Information Technology resources to correctly identify criteria to meet reporting request and ensure the delivered report is accurate, timely, and formatted appropriately.3.Develop timely and accurate data mining techniques to apply to new or existing standardized and ad-hoc reports that ensure consistent conclusions to data analysis.4.Acquire and maintain updated knowledge of the various data sources available within IEHP for reporting, as well as a clear understanding of IEHP business operations to be able to appropriately apply criteria and methodology to meet requestors' needs.5.Manage assigned projects and effectively communicate project deadline issues with the QS Management team in a timely manner. Document all reporting projects and database objects within a project consistently, as instructed by the QS Management team.6.Understanding of regulatory reporting requirements that are supported by the Quality Systems department and facilitate business processes to support those reporting requirements.7.Ability to interpret data trends and data analysis to model and frame business scenarios that will have meaningful impact on critical business processes and/or decisions of QS and IEHP as a whole.8.Collaborate with staff at all levels to solve analytics issues, documenting results and methodologies.9.Collaborate with the data steward to ensure that the information used follows the compliance, access management, and control policies and verify it meets the qualification and assurance requirements of IEHP.10.Serve as facilitator between business units and Information Technology departments to ensure data accuracy, validity, and reliability in support of analytics and reporting needs.11.Research and prepare clear and concise summary reports, narratives, and gap analyses on key topics, as directed.12.Demonstrate a commitment to incorporate LEAN principles into daily work.13.Establish and maintain effective working relationships with others throughout the organization.Major Functions (Duties and Responsibilities) ContSupervisory ResponsibilitiesLeading: SelfExperience Qualifications Minimum of two (2) years of experience and working knowledge of large datasets, creating queries, and developing reports for end users.Preferred Experience Experience in the healthcare field is preferred.Education Qualifications Bachelor's degreefrom an accreditedinstitution required.Preferred Education Master's degreefrom an accredited institution preferred.Professional CertificationProfessional LicensesDrivers License RequiredNoKnowledge Requirement Well-versed in relational database structures and database design. Working knowledge of ICD-10/CPT/HCPCS/NDC coding, strongly desired. Proficient in use of analytical tools such as: MS Access, SAS, Tableau or MS Excel is essential. Will accept extensive knowledge of ArcGIS in lieu of SAS and MS Access.Ability to understand query design and data interpretation.Skills Requirement Strong data analysis, data presentation, spread sheet and database capabilities. Strong communication and interpersonal skills.Abilities Requirement Strong attention to detail.Commitment to Team Culture The IEHP Team environment requires a Team Member to participate in the IEHP Team Culture. A Team Member demonstrates support of the Culture by developing professional and effective working relationships that include elements of respect and cooperation with Team Members, Members and associates outside of our organization.Working Conditions While performing the duties of this job, the employee is occasionally required to stand; walk; sit; use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; climb stairs; balance; stoop, kneel, crouch or crawl; talk or hear; and taste or smell. The employee must occasionally lift or move up to 25 pounds. Specific vision abilities required by the job include close vision, distance vision, color vision, peripheral vision, depth perception and the ability to adjust focus. Position is eligible for Hybrid work location upon completing the necessary steps and receiving HR approval. All IEHP positions approved for telecommute or hybrid work locations may periodically be required to report to IEHP's main campus for mandatory in-person meetings or for other business needs as determined by IEHP leadership.Work Model LocationHybridPhysical RequirementsKeyboarding: Traditional - FREQUENTLYKeyboarding: 10-Key - FREQUENTLYKeyboarding: Touch-Screen - FREQUENTLYHearing: One-on-One - FREQUENTLYCommunicate: Information/ideas verbally - FREQUENTLYNear Visual Acuity - FREQUENTLYRegular contacts: co-workers, supervisor - FREQUENTLYSitting - CONSTANTLYIndoors - FREQUENTLYLighting - CONSTANTLYMemory - FREQUENTLYUnderstand and follow direction - FREQUENTLYRegular and reliable attendance - CONSTANTLY A reasonable salary expectation is between $79,809.60 and $101,774.40, based upon experience and internal equity. Inland Empire Health Plan (IEHP) is the largest not-for-profit Medi-Cal and Medicare health plan in the Inland Empire. We are also one of the largest employers in the region, designated as "Great Place to Work." With a provider network of more than 5,000 and a team of more than 3,000 employees, IEHP provides quality, accessible healthcare services to more than 1.5 million members. And our Mission, Vision, and Values help guide us in the development of innovative programs and the creation of an award-winning workplace. As the healthcare landscape is transformed, we're ready to make a difference today and in the years to come. Join our Team and make a difference with us! IEHP offers a competitive salary and stellar benefit package with a value estimated at 35% of the annual salary, including medical, dental, vision, team bonus, and state pension plan.
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Keywords: Inland Empire Health Plans, Rancho Cucamonga , Quality Systems Analyst I, Professions , Rancho Cucamonga, California