Healthcare Quality Analyst

Emploi pas sur LinkedIn

🕒 il y a 1 mois

🏖️ New Jersey – Distant

🏖️ New Jersey – Remote

💵 $97 800 - $133 455 / an

⏰ Temps Plein

🟡 Intermédiaire

🟠 Senior

🧐 Analyste

👻 Score fantôme 23%

Ce que ça veut dire : la probabilité que cette offre reste ouverte sans recrutement actif.Comment le lire : 60 % ou plus, on pense que c'est une offre fantôme. Un score plus bas est moins inquiétant.Comment on la calcule : ancienneté, republications, postes ouverts vs taille de l'équipe, rapidité de clôture, et si le salaire est indiqué.À noter : une estimation à partir de données publiques, pas un jugement sur l'entreprise. De vraies offres peuvent avoir un score élevé, alors prenez-le comme un indice, pas comme un fait.

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Horizon Connect @ Wall BCBSNJ

Site WebLinkedInTous les Emplois

2 - 10 employés

⚕️ Assurance santé

🏥 Santé

Healthcare Insurance • Healthcare

Horizon Connect @ Wall BCBSNJ est une présence sur LinkedIn ou un programme/bureau local associé à Horizon Blue Cross Blue Shield of New Jersey (BCBSNJ). D'après le nom et le contexte, il semble être lié aux opérations d'assurance santé de Horizon BCBSNJ et à son outreach local ou son engagement auprès des membres/fournisseurs dans la région de Wall, NJ. Les informations disponibles publiquement sont limitées et se concentrent principalement sur l'interface de LinkedIn plutôt qu'un profil d'entreprise, cette description est donc prudente et basée sur l'affiliation indiquée par le nom.

Description

• Responsible for supporting the Quality Management department with improvements through project planning, development and implementation, and the establishment of policies and procedures pertaining to regulations in both Government Programs and Commercial business • Analyzes complex data and information to provide meaningful results, identifying success factors and improvement opportunities, recommending potential solutions to assist the business set strategic goals • Measure performance goals of Medicare STAR Program plans and initiatives to ensure effectiveness of process • Report findings to management and stakeholders as appropriate • Reviews all HPMS and industry correspondence, related to Star Ratings in order to assist and remain current on all information and decision • Ensures that all information necessary for decision making is coordinated and any necessary documentation is prepared • Develop project initiatives, process and performance measures for Quality Management and deliverables to ensure positive outcomes defined by corporate objectives and NCQA and regulatory regulations • Responsible for budgeting, cost containment and strategic planning of systemic enhancements to improve the quality and efficiency of project initiatives and yearly interventions • Collaboratively serve as a HCM&T divisional resource with the Manager for health plan quality ratings • Interacts with internal and external stakeholders to promote HCM&T clinical and operational improvement activities • Provide Consumer Assessment of Healthcare Providers and Systems (CAHPS) coaching to the Horizon providers community to improve the member experience • Interprets member experience performance through various sources of data • Assist in the development of provider improvement action plans to improve member experience and improve CAHPS performance

🎯 Exigences

• High School Diploma/GED required • Bachelor degree preferred or relevant experience in lieu of degree • Requires five (5) years professional business experience working in a health care environment • Prefer five (5) years managed care experience • Requires knowledge of project management methodology • Requires knowledge of healthcare management • Requires working knowledge of PC and application software • Requires knowledge of performance measurement and regulatory reporting • SAS Coding experience strongly preferred • HEDIS/Quality Initiative experience strongly preferred • State Reporting experience strongly preferred

🏖️ Avantages

• Comprehensive health benefits (Medical/Dental/Vision) • Retirement Plans • Generous PTO • Incentive Plans • Wellness Programs • Paid Volunteer Time Off • Tuition Reimbursement