Responsibilities

• Collaborate with Health Plan Risk and Quality leaders to enhance outcomes by managing the Risk/Quality data collection strategy, analytics, and reporting.
• Analyze Risk/Quality rate trends, provider performance measures, CAHPS, and survey analytics, with a focus on health equity and Social Determinants of Health (SDOH).
• Engage external vendors to support performance improvement initiatives and ensure compliance with all regulatory audit guidelines.
• Monitor projects throughout their lifecycle, ensuring successful delivery and adherence to timelines.
• Oversee Risk/Quality data ingestion activities, optimizing the completeness and accuracy of Electronic Health Records (EHR), Health Information Exchange (HIE), and supplemental data.
• Establish and maintain effective relationships with stakeholders, meeting customer expectations and building trust.
• Draw actionable conclusions from data analysis, making informed decisions while collaborating with cross-functional teams.

Requirements

• Bachelor’s degree in a related field; Master’s degree preferred.
• 5+ years of experience in risk management, quality assurance, or healthcare operations.
• Strong analytical skills with proficiency in data analytics tools and methodologies.
• Exceptional project management skills with a proven ability to lead multiple initiatives simultaneously.
• Excellent communication and interpersonal skills to effectively engage with diverse stakeholders.
• Knowledge of healthcare regulations and compliance standards.
• Ability to work independently and as part of a team in a fast-paced environment.

Benefits

• Competitive salary and performance-based bonuses.
• Comprehensive health and wellness benefits, including medical, dental, and vision coverage.
• Generous paid time off and holiday schedule.
• Professional development opportunities and support for continuing education.
• A collaborative and supportive work environment focused on employee growth.
• Flexible work arrangements and a commitment to work-life balance.