Description
Candidates residing in the EST or CST Time zones preferred for this position
Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.
Medical Mutual' s status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life.
Responsibilities
Clinical Quality Data Analyst I
Supports the design, execution and delivery of analyses and reports to provider groups and internal stakeholders. Assists in data gathering for quality improvement and in-depth analyses and recommendations that improve care and health plan quality ratings. Collaborates with internal team to design, create and deliver reporting and analytic results.
· Collaborates with team, department leadership, and internal stakeholders to gather, document and execute analytic and reporting requirements. Incorporates feedback to improve content and format of deliverables. Interacts with internal and external stakeholders.
· Analyzes data, creates reports, and presents results to inform strategic decision making.
· Manages multiple assignments with competing deadlines. Works with team and manager to prioritize deliverables. Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and manager.
· Contributes to development and enhancement of analytic tools and deliverables. Actively participates in department and team meetings. Completes trainings to maintain and enhance knowledge, skills and abilities.
· Performs other duties as assigned.
Clinical Quality Data Analyst II
Designs, executes and delivers analyses and reports to provider groups and internal stakeholders. Identifies actionable opportunities in data through quality improvement and in-depth analyses and recommendations that improve care and health plan quality ratings. Collaborates with provider engagement and provider groups to design, create and deliver reporting and analytic results.
· Collaborates with team, department leadership, and internal stakeholders to gather, document and execute analytic and reporting requirements. Explains technical details, relevance and implications of analytic results to diverse audiences. Incorporates feedback to improve content and format of deliverables. Interacts with internal and external stakeholders.
· Analyzes data, creates reports, and presents results to inform strategic decision making. Directs stakeholders to appropriate analyses and value-added information beyond what is requested.
· Manages multiple projects with competing deadlines. Works with team and department leadership to prioritize deliverables. Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders.
· Contributes to development and enhancement of analytic tools and deliverables. Actively participates in department and team meetings. Completes trainings to maintain and enhance knowledge, skills and abilities.
· Performs other duties as assigned.
Clinical Quality Data Analyst III
Designs, executes and delivers analyses and reports to provider groups and internal stakeholders. Identifies actionable opportunities in data through quality improvement and in-depth analyses and recommendations that improve care and health plan quality ratings. Collaborates with provider engagement and provider groups to design, create and deliver reporting and analytic results.
· Analyzes data, creates reports, and presents results to inform strategic decision making. Directs stakeholders to appropriate analyses and value-added information beyond what is requested.
· Collaborates with team, department leadership, and internal stakeholders to gather, document and execute analytic and reporting requirements. Explains technical details, relevance and implications of analytic results to diverse audiences. Incorporates feedback to improve content and format of deliverables. Interacts with internal and external stakeholders.
· Manages multiple projects with competing deadlines. Works with team and department leadership to prioritize deliverables. Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders.
· Contributes to development and enhancement of analytic tools and deliverables. Actively participates in department and team meetings. Completes trainings to maintain and enhance knowledge, skills and abilities.
· Performs other duties as assigned.
Sr. Clinical Quality Data Analyst
Designs, executes and delivers analyses and reports to provider groups and internal stakeholders on key quality indicators for Healthcare Effectiveness Data and Information Set (HEDIS) and STARS. Identifies actionable opportunities in data through quality improvement and in-depth analyses and recommendations that improve care and health plan quality ratings across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid). Collaborates with provider engagement and provider groups to design, create and deliver reporting and analytic results. Supports quality improvement initiatives by collaborating with management. Consults with and informs business stakeholders of trends, opportunities, and risks.
· Leads in the creation of data analyzes and reports. Presents results to inform strategic decision making. Collaborates with internal and external stakeholders to provide appropriate analyses and makes value-added recommendations beyond what is requested.
· Leads collaboration with team, department leadership, and internal stakeholders to gather, document and execute analytic and reporting requirements in compliance with HEDIS technical specifications, policies and operating procedures. Explains technical details, relevance and implications of analytic results to diverse audiences. Incorporates feedback to improve content and format of deliverables. Interacts with internal and external stakeholders.
· Manages multiple projects with competing deadlines. Works with team and department leadership to prioritize deliverables. Leads coordination with team to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders.
· Leads in the development and collaborative enhancement of analytic tools and deliverables. Actively participates in department and team meetings. Maintains up to date knowledge and understanding of technical specifications for all HEDIS measures. Leads collaborative review of mapping documentation for annual HEDIS Specification update application and coordinates implementation.
· Orients, assists, trains, mentors, coaches and reviews work of more junior-level Analyst. May supervise staff in absence of Manager.
· Participates in required training and performs other duties as assigned.
Lead Clinical Quality Data Analyst
Working under minimal supervision, supports quality improvement initiatives by collaborating with management. Consults with and informs business stakeholders of trends, opportunities, and risks. Leads work unit in design, execution and analytic deliverables for provider groups and internal stakeholders on key quality indicators for Healthcare Effectiveness Data and Information Set (HEDIS) and STARS. Leads team in identification and recommendation of actionable opportunities in data through quality improvement and in-depth analyses. Fosters ongoing development of individual team member strengths that lend toward continuous improvement and manages all aspects of improvement implementation. Supports improved care and health plan quality ratings across all lines of business (Commercial, Marketplace, Medicare Advantage, and Medicaid). Promotes collaboration with provider engagement and provider groups to design, create and deliver reporting and analytic results.
· Schedules, assigns, and monitors projects and prioritizes work based on competing deadlines. Provides peer review, training, and oversight. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders. May provide input in hiring, development, and performance evaluations of more junior analysts.
· Helps devise and implement clinical quality analytic strategy, priorities, and continuous improvement. Oversees work unit creation of data analyzes and reports. Presents results to inform strategic decision making. Collaborates with internal and external stakeholders to provide appropriate analyses and makes value-added recommendations beyond what is requested.
· Leads collaboration with team, department leadership, and internal stakeholders to gather, document and execute analytic and reporting requirements in compliance with HEDIS technical specifications, policies, and operating procedures. Explains technical details, relevance, and implications of analytic results to diverse audiences. Incorporates feedback to improve content and format of deliverables. Builds and inspires collaborative relationships within the team and with internal and external stakeholders.
· Leads in the development and collaborative enhancement of analytic tools and deliverables. Actively participates in department and team meetings. Maintains up to date knowledge and understanding of technical specifications for all HEDIS measures, regulations, and best practices. Serves as a Subject Matter Expert to management and other departments. Leads collaborative review of mapping documentation for annual HEDIS Specification update application and coordinates implementation.
· Performs other duties as assigned.
Qualifications
Qualifications
Clinical Quality Data Analyst I
Education and Experience:
· Bachelor's degree in healthcare administration, business administration, information technology or a related field .
· Up to 1 year of experience conducting analyses and delivering analytic results in a health care insurance, consulting or delivery organization.
Technical Skills and Knowledge:
· Basic knowledge of health plan operations, data sources, and data structures. Basic understanding of claim submissions and database management.
· Basic knowledge of Extract, Transform, and Load (ETL) data processes.
· Basic knowledge of HEDIS, NCQA and CMS Stars.
· Basic to intermediate skills in database reporting and familiarity with data extraction and analytical programming languages (SAS, SQL), and data visualization tools (Tableau).
· Good project management skills.
· Ability to draft analytical assessments and summarize content.
Clinical Quality Data Analyst II
Education and Experience:
· Bachelor's degree in healthcare administration, business administration, information technology or a related field.
· 2 years of experience as a Clinical Quality Data Analyst or equivalent experience conducting analyses and delivering analytic results in a health care insurance, consulting, or delivery organization.
· HEDIS experience preferred.
Technical Skills and Knowledge:
· Knowledge of health plan operations, data sources, and data structures, including trends and drivers of quality. Basic understanding of claim submissions and database management.
· Knowledge of Extract, Transform, and Load (ETL) data processes.
· Knowledge of HEDIS, NCQA and CMS Stars quality metrics.
· Knowledge of health plan data sources.
· Intermediate to advanced skills in database reporting and familiarity with data extraction and analytical programming languages (SAS, SQL), and data visualization tools (Tableau).
· Good project management skills.
· Ability to draft analytical assessments and summarize content.
Clinical Quality Data Analyst III
Education and Experience:
· Bachelor's degree in healthcare administration, business administration, information technology or a related field .
· 3 years of experience as a Clinical Quality Data Analyst or equivalent experience conducting analyses and delivering analytic results in a health care insurance, consulting, or delivery organization.
· HEDIS experience preferred.
Technical Skills and Knowledge:
· Strong knowledge of health plan operations, data sources, and data structures, including trends and drivers of quality. Basic understanding of claim submissions and database management.
· Knowledge of Extract, Transform, and Load (ETL) data processes.
· Knowledge of HEDIS, NCQA and CMS Stars quality metrics.
· Knowledge of health plan data sources.
· Intermediate to advanced skills in database reporting and expertise in data extraction and analytical programming languages (SAS, SQL), and data visualization tools (Tableau).
· Good project management skills.
· Ability to draft analytical assessments and summarize content to non-technical audience.
Sr. Clinical Quality Data Analyst
Education and Experience:
· Bachelor's degree in healthcare administration, business administration, information technology or a related field .
· Master's degree (MBA, MPH, or MHA) preferred.
· 5 years progressive experience as a Clinical Quality Data Analyst or equivalent experience conducting analyses and delivering analytic results in a health care, health insurance, consulting or delivery organization.
· HEDIS experience preferred.
Technical Skills and Knowledge:
· Advanced knowledge of health plan operations, data sources, and data structures, including trends and drivers of quality. Solid understanding of claim submissions and database management.
· Advanced knowledge of Extract, Transform, and Load (ETL) data processes.
· Advanced knowledge of HEDIS, NCQA and CMS Stars quality metrics.
· Advanced knowledge of health plan data sources.
· Advanced skills in database reporting and expertise in data extraction and analytical programming languages (SAS, SQL), and data visualization tools (Tableau).
· Strong project management skills.
· Demonstrated ability to draft analytical assessments and summarize content to non-technical audience.
· Ability in identify opportunities and propose solutions.
· Ability to develop and produce complex reports and dashboards.
· Ability to draft analytical assessments and summarize content in simplified language.
· Ability to design and execute analyses to evaluate the effectiveness of interventions and initiatives to improve quality.
Lead Clinical Quality Data Analyst
Education and Experience:
· Bachelor's degree in healthcare administration, business administration, information technology or a related field.
· Master's degree (MBA, MPH, or MHA) preferred.
· 7 years progressive experience as a Clinical Quality Data Analyst or equivalent experience conducting analyses and delivering analytic results in a health care, health insurance, consulting, or delivery organization.
· HEDIS experience preferred.
Technical Skills and Knowledge:
· Advanced knowledge of health plan operations, data sources, and data structures, including trends and drivers of quality. Solid understanding of claim submissions and database management.
· Advanced knowledge of Extract, Transform, and Load (ETL) data processes.
· Advanced knowledge of HEDIS, NCQA and CMS Stars quality metrics and the ability to apply concepts to business operations.
· Advanced knowledge of health plan data sources.
· Advanced skills in database reporting and expertise in data extraction and analytical programming languages (SAS, SQL), and data visualization tools (Tableau).
· Strong project management skills.
· Demonstrated ability to draft analytical assessments and summarize content to non-technical audience.
· Ability in identify opportunities and propose solutions.
· Ability to develop and produce complex reports and dashboards.
· Ability to draft analytical assessments and summarize content in simplified language.
· Ability to design and execute analyses to evaluate the effectiveness of interventions and initiatives to improve quality.
Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:
A Great Place to Work:
- We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
- Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
- On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
- Discounts at many places in and around town, just for being a Medical Mutual team member.
- The opportunity to earn cash rewards for shopping with our customers.
- Business casual attire, including jeans.
Excellent Benefits and Compensation:
- Employee bonus program.
- 401(k) with company match up to 4% and an additional company contribution.
- Health Savings Account with a company matching contribution.
- Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
- Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
- Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
- After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.
An Investment in You:
- Career development programs and classes.
- Mentoring and coaching to help you advance in your career.
- Tuition reimbursement up to $5,250 per year, the IRS maximum.
- Diverse, inclusive and welcoming culture with Business Resource Groups.
About Medical Mutual:
Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.
There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.
We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.
At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.
We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.
Apply on company website
Find Connections via Linkedin
