Quality Improvement Analyst, Senior- Remote (Health Plan Experience)

UPMC Health Plan has an exciting opportunity for a Quality Improvement Analyst, Senior position in the Medicare department. This is a full time position working Monday through Friday daylight hours. This is a remote, preferably in the Eastern Standard Time Zone. Applicants with Health Plan experience will be highly considered.

The Quality Improvemet Analyst, Senior will manage comprehensive analysis of data and information for various UPMC Health Plan products and programs. Quality Improvement Analyst will take a leadership role in the enhancement, development, documentation, and communication of identified variances and assessment of strategic opportunities. To successfully perform the role, the Quality Improvement Analyst must be highly professional and understand the causes of quality, clinical trends, and anomalies. The Quality Improvement Analyst must use their knowledge and understanding of quality, clinical and other information generated by numerous sources to identify opportunities to improve clinical and quality performance. Furthermore, the position requires the ability to articulate these opportunities to internal and external audiences, implement the solutions, and track and monitor progress. These functions must be done while also weighing the practical considerations and potential barriers that need to be overcome in order to successfully implement new programs and processes.

Responsibilities:

• Independently prioritize and manage 3-to-5 advanced quantitative and/or statistical analytics projects simultaneously, while receiving regular supervision.
• Routinely apply advanced data extraction and manipulation skills, complex analysis methods, statistical analysis, and data visualization tools to daily work.
• Independently, or in teams, produce a combination of quality analysis and clinical utilization analysis to produce new insights into drivers of Health Plan performance.
• Routinely analyze quality and clinical results
• Demonstrate attention to detail and initiative in discovering errors in data or analyses, or determining the need for additional, follow-up analysis arising from the original assignment.
• Develop knowledge and expert understanding of all products and benefit designs of UPMC Health Plan insurance offerings, across all lines of business, to facilitate analysis.
• Produce customer-oriented reports that provide business context for the analysis and recommendations, requiring only moderate revision by the supervisor or analytics communications team.
• The quantitative analyst will also become increasingly familiar with basic medical claims terminology in order to properly interpret, through the application of quality analytics, the impact of care delivery on Health Plan performance.
• The QIA, Senior will consistently demonstrate a strong customer orientation, producing analyses on-time and communicating results effectively.
• Quality Improvement is a fluid, dynamic, fast-paced environment.
• The successful employee is comfortable with ambiguity in priorities and is able to maintain professionalism and a team-player attitude in the face of analytical challenges of moderate-to-high complexity.
• Bachelor's degree in business, mathematics, statistics, health care management, decision sciences, or a similar field, or equivalent work experience.
• Master's degree preferred.
• Minimum of four years of work experience in an analytics job function; six years are preferred.
• Demonstrated expertise in particularly-relevant analytical methods or health care business domain may reduce time-in-position requirements.
  
  

Licensure, Certifications, and Clearances:

• Act 34
  
  

UPMC is an Equal Opportunity Employer/Disability/Veteran