What are the responsibilities and job description for the Clinical Quality Analytics, Consultant position at Blue Sheild Of California?
Blue Shield of California’s mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that truly serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience.
To fulfill our mission, we must ensure a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve. Our comprehensive approach to diversity, equity, and inclusion combines a focus on our people, processes, and systems with a deep commitment to promoting social justice and health equity through our products, business practices, and presence as a corporate citizen.
Blue Shield has received awards and recognition for being a certified Great Place to Work, best place to work for LGBTQ equality, leading disability employer, one of the best companies for women to advance, Bay Area’s top companies in volunteering & giving, and one of the world’s most ethical companies. Here at Blue Shield of California, we are striving to make a positive change across our industry and the communities we live in – join us!
Your Role
The Clinical Quality Analytics and Informatics team delivers best-in-class clinical quality analytics and informatics to enable high quality and affordable member-centered care. Our data, intelligence, and actionable insights help drive quality strategy, performance improvement, and regulatory reporting. The Clinical Quality Analyst - Consultant will report to the Clinical Quality Analytics Senior Manager with day-to-day oversight provided by the CalPERS analytic lead. In this role you will provide data, analytic and reporting support, in partnership with the Clinical Quality Department, for the BSC CalPERS HMO / PPO lines of business. This includes monthly executive reporting, tableau dashboards, member engagement and adhoc analytics.
Your Work
In this role, you will :
- Conduct independent analysis of high complexity under minimal supervision and guidance
- Develop analytical methods so that they may be subsequently delegated for production to Clinical Quality Analysts at lower levels
- Produce analysis of high complexity under the guidance and direction of Clinical Quality Analyst – Principal or manager
- Develop documentation and create and execute workplans for analyses of high complexity. Workplans may coordinate the activities of Clinical Quality Analysts at lower levels and may involve collaboration with more than one team
- Provide training and mentoring for team members on best practices for analysis and reporting; assist in the development of supplemental analytic training tools and materials; conducts formal training sessions for lower level analysts and analysts in other Departments.
- Conduct independent analysis of high complexity under moderate supervision and guidance, develop novel analyses and reports
- Collect data from various internal systems (e.g. Claims processing or membership systems) and external systems (EMR / EHR) and converts those data to actionable insights to guide business decision making for BSC populations' health management and quality of care
- Develop, implement, and document quality assurance (QA) processes to ensure that reported data is accurate and reliable
- Conduct program evaluation, vendor assessments, performance guarantees using advanced statistical modeling
- Partner with the HEDIS data team, Clinical Quality Analytics and Medical Record Review teams to support HEDIS performance improvement initiatives
Your Knowledge and Experience
Our Values
Honest . We hold ourselves to the highest ethical and integrity standards. We build trust by doing what we say we're going to do and by acknowledging and correcting where we fall short
Human . We strive to be our authentic selves, listening and communicating effectively, and showing empathy towards others by walking in their shoes
Courageous . We stand up for what we believe in and are committed to the hard work necessary to achieve our ambitious goals