Demo

RN - Clinical Quality Analyst

Oscar Health
New York, NY Full Time
POSTED ON 2/5/2025
AVAILABLE BEFORE 5/5/2025

Job Description

Job Description

Hi, we're Oscar Medical Group. We're hiring a Clinical Quality Analyst to join our Oscar Medical Group team.

At Oscar Medical Group, we are refactoring healthcare. We want to help each of our members achieve their healthcare goals in a personalized way. To help us achieve that goal we are looking for innovative leaders who think big and push boundaries to refactor healthcare and the healthcare delivery system.

About the role :

You will support the clinical care team in providing high quality, safe patient care in our virtual clinic. You are responsible for collecting, analyzing, and interpreting data related to patient safety, quality of care, and regulatory compliance. You will conduct patient safety incident reviews. You will work with clinical leadership, operations, and compliance teams to identify and address potential risk, implement quality improvement initiatives and ensure compliance with all applicable regulations and standards.

You will report into the Senior Medical Director, Oscar Primary Care.

Work Location :

Oscar Medical Group is a blended work culture where everyone, regardless of work type or location, feels connected to their teammates, our culture and our mission.

This is a remote / work-from-home role. You must reside in one of the following states : Arizona, California, Colorado, Florida, Georgia, Illinois, Massachusetts, Michigan, Nevada, New Jersey, New York, North Carolina, Ohio, Pennsylvania, Texas, or Virginia. Note, this list of states is subject to change. #LI-Remote

Pay Transparency :

The base pay for this role is : $72,800 - $95,550 per year. You are also eligible for employee benefits, and annual vacation grant of up to 18 days per year and annual performance bonuses.

Responsibilities :

  • Data collection and analysis

Analyze and report out trends related to quality initiatives, HEDIS metrics, NPS / patient complaints, and safety issues to OscarCare, OMG leadership, and Compliance

  • Patient Safety incident review and mitigation action plans
  • Perform incident reviews in timely manner with closed loop feedback

  • Develop mitigation action plans in collaboration with clinical leadership for future risk reduction and process improvement
  • Trend and track reported events, themes, and preparation of summary reports for Safety and Compliance Committee meetings and stakeholders
  • Risk Management & Regulatory Compliance
  • Demonstrate expert knowledge in all internal policies as well as general knowledge of healthcare regulation

  • Provide feedback for improvements in internal policies and standard operating procedures to support Compliance and Risk Management
  • Quality assurance and process improvement
  • Conduct structured, targeted chart audits related to quality and HEDIS metrics

  • Synthesize and share findings of chart audits with cross functional clinical leaders and teams working on quality / performance improvement
  • Collaborate with operations and product teams in investigation and mitigations of systems issues and internal product / EMR patterns
  • Conduct investigations into formal patient complaints, PQIs, and NPS feedback
  • Education and training
  • Maintain and develop patient safety and quality training materials for OMG

  • Compliance with all applicable laws and regulations
  • Other duties as assigned
  • Requirements :

  • Minimum of Bachelor of Science in Nursing (BSN), but may hold a Master's degree in Nursing (MSN)
  • 3 years of experience in patient safety, quality improvement, or risk management
  • 5 years of experience as registered nurse in ambulatory or hospital setting
  • Bonus points :

  • 1 years proficiency in google suites applications and presentations to leadership
  • Experience as registered in nurse in telehealth setting
  • Patient Safety certification including but not limited to one of the following : CPPS, CSHM, CSP, CSS
  • Quality certification including but not limited to one of the following : CPHQ
  • Experience with Symplr platform or other patient safety tracking tools
  • Experience with NCQA, HEDIS, STARS, CAHPs metrics including monitoring and reporting
  • This is an authentic Oscar Health job opportunity. Learn more about how you can safeguard yourself from recruitment fraud here.

    At Oscar, being an Equal Opportunity Employer means more than upholding discrimination-free hiring practices. It means that we cultivate an environment where people can be their most authentic selves and find both belonging and support. We're on a mission to change health care an experience made whole by our unique backgrounds and perspectives.

    Pay Transparency : Final offer amounts, within the base pay set forth above, are determined by factors including your relevant skills, education, and experience. Full-time employees are eligible for benefits including : medical, dental, and vision benefits, 11 paid holidays, paid sick time, paid parental leave, 401(k) plan participation, life and disability insurance, and paid wellness time and reimbursements.

    Reasonable Accommodation : Oscar applicants are considered solely based on their qualifications, without regard to applicant's disability or need for accommodation. Any Oscar applicant who requires reasonable accommodations during the application process should contact the Oscar Benefits Team (accommodations@hioscar.com) to make the need for an accommodation known.

    California Residents : For information about our collection, use, and disclosure of applicants' personal information as well as applicants' rights over their personal information, please see our Notice to Job Applicants.

    Salary : $72,800 - $95,550

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