Data Analyst Sr (Quality Analytics)

Data Analyst Sr (Quality Analytics)

CalOptima

CalOptima Health is seeking a highly motivated an experienced Data Analyst Sr (Quality Analytics) to join our team. The Data Analyst Sr (Quality Analytics) will provide expertise in quality reporting and analysis requirements for the Quality Analytics department. The incumbent will be responsible for executing data collection, data processing, data analysis, reporting and quality assurance of data integrity based on business needs and presenting results effectively to internal and external stakeholders and management. The incumbent will provide subject matter expertise and train analysts as needed. The incumbent will communicate updates and analysis results to stakeholders, which may include deliverables related to but not limited to Healthcare Effectiveness Data and Informational Set (HEDIS), Managed Care Accountability Set (MCAS), Stars quality measures, Timely Access and Consumer Assessment of Healthcare Providers and Systems (CAHPS) quality measures. The incumbent will act as the primary liaison with other departments to help procure data required to meet business needs, which includes participating in data integration activities.

Position Information

• Department: Quality Analytics
• Salary Grade: 312 - $84,092 - $134,548 ($40.43 - $64.6865)
• Work Arrangement: Full Telework
• This position is eligible for telework in California.**
  
  

Duties & Responsibilities

• 80% - Data and Reporting Support
• Leads and monitors the data analysis activities in the Quality Analytics department.
• Creates reports from specifications using a multitude of data sources to transform data into information, which informs and enables stakeholders to monitor and report quality and population health metrics.
• Participates in various Quality Analytics and organizational meetings with collaborating departments, such as Enterprise Analytics and Information Technology Services (ITS) to define data needs.
• Supports the integration of various data feeds, including HEDIS Electronic Clinical Data Systems (ECDS), Electronic Medical Records, informational dashboards and various sources.
• Generates and maintains reports and queries from various sources, such as the data warehouse and HEDIS engine.
• Prepares formal reports, narrative summaries and findings for various business needs, regulatory requirements or National Committee for Quality Assurance (NCQA) standard submissions; evaluates reports for accuracy of data, including the application of standardized analysis and assists in the timely production of reports.
• Conducts quality assurance on data, reviews results for accuracy and prepares data deliverables for regulatory or internal business needs.
• Provides data forecasting and trend analysis for various business needs.
• Assists with survey design and analysis.
• Maintains or builds data repository as needed.
• Maintains thorough knowledge of CalOptima Health's data and provides feedback to ITS to resolve data integrity issues and support reporting requirements.
• Prepares complex ad-hoc analyses and works on special projects.
• Provides subject matter expertise and technical analysis to staff, agencies and other departments as needed on collaborative projects.
• 15% - Program Support
• Participates in a mission-driven culture of high-quality performance, with a member focus on customer service, consistency, dignity and accountability.
• Assists the team in carrying out department responsibilities and collaborates with others to support short- and long-term goals/priorities for the department.
• Guides other Data Analysts in evaluating data and meeting customer specifications and business needs.
• Provides support to the Quality Analytics department projects that require quality measure data and analysis.
• 5% - Other
• Completes other projects and duties as assigned.
  

Minimum Qualifications

• Bachelor's degree in healthcare administration, public health, data analytics, business administration, information systems (informatics) or related field PLUS 5 years of experience analyzing data and developing/designing reports in a managed care or health care organization required; an equivalent combination of education and experience sufficient to successfully perform the essential duties of the position such as those listed above may also be qualifying.
• 2 years of experience in SQL with relevant experience in a Microsoft SQL Server environment, relational database concepts or file structures required.
  
  

Preferred Qualifications

• Master's degree in healthcare administration, data analytics, business administration, information systems (informatics) or related field.
• Project Management Professional (PMP) certification.
• 2 years of HEDIS reporting experience.
• Project management experience.
  
  

Required Licensure / Certifications

• N/A
  
  

Knowledge & Abilities

• Develop rapport and establish and maintain effective working relationships with CalOptima Health's leadership and staff and external contacts at all levels and with diverse backgrounds.
• Work independently and exercise sound judgment.
• Communicate clearly and concisely, both orally and in writing.
• Work a flexible schedule; available to participate in evening and weekend events.
• Organize, be analytical, problem-solve and possess project management skills.
• Work in a fast-paced environment and in an efficient manner.
• Manage multiple projects and identify opportunities for internal and external collaboration.
• Motivate and lead multi-program teams and external committees/coalitions.
• Utilize computer and appropriate software (e.g., Microsoft Office: Word, Outlook, Excel, PowerPoint) and job specific applications/systems to produce correspondence, charts, spreadsheets, and/or other information applicable to the position assignment.
  
  

Physical Requirements (With Or Without Accommodations)

• Ability to visually read information from computer screens, forms and other printed materials and information.
• Ability to speak (enunciate) clearly in conversation and general communication.
• Hearing ability for verbal communication/conversation/responses via telephone, telephone systems, and face-to-face interactions.
• Manual dexterity for typing, writing, standing and reaching, flexibility, body movement for bending, crouching, walking, kneeling and prolonged sitting.
• Lifting and moving objects, patients and/or equipment 10 to 25 pounds
  
  

Work Environment

If located at the 500, 505 Building or a remote work location:

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• There are no harmful environmental conditions present for this job.
• The noise level in this work environment is usually moderate.
  
  

If Located At PACE

• Work is typically indoors in a clinical setting serving the frail and elderly.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.
  
  

If Located In The Community

• Work is typically indoors and sedentary and is subject to schedule changes and/or variable work hours, with travel as needed.
• Employee will occasionally work outdoors in varied temperatures.
• There may be harmful or hazardous environmental conditions present for this job.
• The noise level in this work environment is usually moderate to loud.
  
  

About CalOptima Health

CalOptima Health is the single largest health plan in Orange County, serving one in four residents. Our motto - "Better. Together." - is at the heart of our mission to serve members with excellence, dignity and respect. We are a public agency made up of compassionate leaders and professionals working together to strengthen our community's health. We are continuing to build a culture that promotes diversity and inclusion within our community where employees have a sense of belonging, and are valued for their ideas, contributions, and their unique individual perspectives they bring. CalOptima Health has been recognized as one of Orange County's best places to work, so we know there is something special about our organization. It is why people choose to work here and why they choose to stay!

About Our Benefits & Wellness Options

At CalOptima Health, we know that a healthy and happy workforce is a thriving workforce, which is why we offer a comprehensive benefits package, including participation in the California Public Employees Retirement System (CalPERS), low-cost medical/vision/dental insurance options, and paid time off. To support quality work-life balance, we allow flexible scheduling during core business hours, telework options for some positions, and a wellness program featuring diverse activities. Additionally, CalOptima Health contributes 4% of pensionable earnings to a 401(a) retirement program with no required employee contribution. For those who are interested in additional retirement savings, employees have access to 457(b) retirement plans with pre/post-tax contribution options. For more information, please click on the 2025 CalOptima Health Benefits Guide regarding our comprehensive benefits and wellness package.

IMPORTANT APPLICATION INFORMATION AND INSTRUCTIONS

Applications will be accepted on a continuous basis until a sufficient number of qualified applications have been received. The deadline for the first review of applications is April 30, 2025 at 9:00 PM (PST). Applicants are encouraged to apply early. Applicants that apply after the first review are not guaranteed to be considered for this recruitment. This recruitment may close at any time without notice after the first review date.

The selection process may include, but is not limited to, a skills assessment, phone screen and interview.

The successful candidate will be required to undergo a reference / background check (to include a conviction record) and if applicable also pass a post-offer pre-employment medical examination (which will include a drug screening). Internal CalOptima Health applicants should apply through InfoNet.

Communication regarding your application will be sent to the email address listed on your application. Please check your email, including your SPAM folder, regularly throughout the recruitment process. You can also visit your candidate portal to receive the most up to date status of your application.

CalOptima Health is committed to attracting, hiring, and retaining a diverse staff, where we will honor your unique experiences, identity, and perspectives. Our organization strives to create and maintain a workplace environment that is inclusive, equitable and welcoming so we can truly be Better Together.

CalOptima Health is an equal opportunity employer and makes all employment decisions on the basis of merit. CalOptima Health wants to have qualified employees in every job position. CalOptima Health prohibits unlawful discrimination against any employee, or applicant for employment, based on race, religion/religious creed, color, national origin, ancestry, mental or physical disability, medical condition, genetic information, marital status, sex, sex stereotype, gender, gender identity, gender expression, transitioning status, age, sexual orientation, immigration status, military status as a disabled veteran, or veteran of the Vietnam era, or any other consideration made unlawful by federal, state, or local laws. CalOptima Health also prohibits unlawful discrimination based on the perception that anyone has any of those characteristics or is associated with a person who has, or is perceived as having, any of those characteristics.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation at (714) 246-8400 if you are unable or limited in your ability to access job openings or apply for a job on this site as a result of your disability.

To apply, please visit: https://jobs.caloptima.org/jobs/data-analyst-sr-quality-analytics-505-city-parkway-west-california-united-states

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