Clinical Quality Management Analyst

US-IA-Des Moines
Job ID
Clinical/Provider Support
Requires Non-Compete?

Job Summary

We’re hiring a Clinical Quality Management Analyst to join the Quality Management and Accreditation team! In this role, you will provide integrated and comprehensive reporting, consultative, and analytical expertise for and on behalf of the Quality Management Team. This includes providing direction on data collection, analysis, and advanced analytical reporting that is complete, accurate and timely to drive continuous improvement. You will generate reports and dashboards, and provide interpretation and analysis of the data that will inform the development of corrective action plans.   In collaboration with other business areas, you will summarize results and develop program conclusions (i.e. HEDIS) for the Quality Management team, leaders, and internal and external stakeholders.  Additionally, you will participate in the development and maintenance of standard and required reporting business rules that support decision making efforts to improve overall clinical quality. Sound like a fit? Consider applying today!


Core Competencies:

  • Accountability: Owning and taking responsibility for one’s actions.
  • Business Acumen: Understanding industry, market, financial and company specific operations.
  • Collaboration and Communication: Working together; listen to other’s ideas; communicate accurately and concisely.
  • Decision Making: Consider all facts and impacts when making decisions.
  • Focus on the Customer: Consistently doing what is in the best interest of our customer. Leaving a positive impression on the customer by elevating their experience; making it simpler and educating to helping them understand.

Minimum Qualifications Required (all must be met to be considered)

  • Bachelor’s degree in statistics, epidemiology, mathematics, analytics, or a related area of study, or direct and applicable work experience.
  • 3+ years of experience working in business analytics, reporting, analysis, or related role with at least 2+ years analyzing health care related data – e.g., claims, quality improvement, etc.
  • Data management and data collection skills with strong attention to detail. Technical aptitude to learn new data management and analysis tools or methodologies quickly. Knowledge of SQL; direct experience is a plus.
  • Effective consultation, analysis, and critical thinking skills with the ability to review data and provide measureable outcomes and trend measures to support and influence business decisions.
  • Strong written and verbal communications skills with the ability to share technical insights and recommendations with varying stakeholder audiences.
  • Self-starter able to produce quality results based off of sound decision making skills. Effective time management of tasks with flexibility and adaptability to change.
  • Collaborative approach to work with ability to partner with different business areas.


Hiring Specifications Preferred

  • Bachelor’s degree in statistics, epidemiology, mathematics, analytics, or a related area of study.
  • Active and unrestricted RN license in Iowa.
  • Previous HEDIS experience, including measurement and analysis of clinical outcomes/gaps.

Job Accountabilities

a. Extract, analyze, interpret, integrate, and report using internal and external data sources to inform corrective action plan development and clinical quality improvement. Draw conclusions and support recommendations made to stakeholders that will help to achieve business goals.

b. Responsible for analysis of health data i.e. HEDIS and interprets results and makes recommendations based on findings. Acts as lead on HEDIS and other metrics and utilization for program and enterprise projects.

c. Apply complex qualitative and quantitative analysis techniques to interpret data in support of the Quality Management program and Accreditation.

d. Collaborate with internal stake holders and/or external vendors for the definition, design, execution, and maintenance of data extracts to ensure critical business requirements and needs are met and maintained.

e. Collaborate with the Business analytics and Innovation team in meeting the quality reporting needs of stakeholders. Work closely to integrate and support cross functional quality initiatives and programs.

f. Collaborate with internal stake holders and external vendors on the definition, design and execution and maintenance of data extracts to meet critical business requirements. Accountable for the integrity of the data and business intelligence infrastructures.

g. Manage multiple tasks, data collection and reporting initiatives while supporting participation in cross-functional projects and other initiatives.

h. Independently complete reports, dashboards and analytical tasks. Assist with and support complex reports and analytic tasks including basic statistical analysis, what if analyses, and other analytical techniques.

i. Other duties as assigned.


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