Provider Performance Analyst

Job Description

Job Description

Provider Performance Analyst

Location: Birmingham, AL

Why VIVA HEALTH?

VIVA HEALTH, part of the renowned University of Alabama at Birmingham (UAB) Health System, is a health maintenance organization providing quality, accessible health care. Our employees are a part of the communities they serve and proudly partner with members on their healthcare journeys.

VIVA HEALTH has been recognized by Centers for Medicare & Medicaid Services (CMS) as a high-performing health plan and has been repeatedly ranked as one of the nation's Best Places to Work by Modern Healthcare.

Benefits

• Comprehensive Health, Vision, and Dental Coverage
• 401(k) Savings Plan with company match and immediate vesting
• Paid Time Off (PTO)
• 9 Paid Holidays annually plus a Floating Holiday to use as you choose
• Tuition Assistance
• Flexible Spending Accounts
• Healthcare Reimbursement Account
• Paid Parental Leave
• Community Service Time Off
• Life Insurance and Disability Coverage
• Employee Wellness Program
• Training and Development Programs to develop new skills and reach career goals
• Employee Assistance Program

See more about the benefits of working at Viva Health -

Job Description

The Provider Performance Analyst is responsible for applying advanced analytical and technical skills to provide reporting and analytics as well as assisting in efforts to improve the operational success of the organizations’ Connect 4 Quality (C4Q) performance. This role uses a variety of data sources to determine performance across current and emerging Star/HEDIS measures, identifies insights and opportunities for performance improvements, and shares these findings with stakeholders to drive continuous improvement.

This position will assist with preparation of materials addressing C4Q performance for internal and external meetings as directed. This position supports analytics for additional corporate initiatives related to C4Q performance including but not limited to provider incentives, Star/HEDIS measures, and population health management. This
individual will be responsible to work both independently and collaboratively on a variety of tasks and be a key contributor the C4Q team.

Key Responsibilities

• Work with department leaders to determine and fulfill data reporting and analysis needs. Develop and prepare reports and dashboards to support initiatives for C4Q performance.
• Responsible for accurate and thorough data integrity and scrubbing. Define and develop automation of analysis tasks, queries, and reports to pinpoint trends, correlations, and patterns in complicated data sets. Quickly identify relevant information and transform it into meaningful output. Develop thoughtful presentations back to management and/or stakeholders with actionable findings for improvement.
• Execute data analysis and reporting to maximize Company performance on healthcare quality improvement measurements primarily through data retrieval and data analysis tools such as Excel, Tableau, SQL, Crystal, SAS, etc.
• Establish, organize, and maintain knowledge of C4Q measure data Technical Specifications, statistical methodologies/calculations, and source tables. Present such information to management and/or stakeholders as required.
• Research, evaluate, and find solutions for departmental data integrity or software issues. Ensure accuracy of data sources used for reporting; assist with quality assurance and troubleshooting as needed.
• Assist with organization and documentation of Company data warehouse pertaining to quality improvement reporting.
• Create data processes that are consistent, repeatable, and scalable.

REQUIRED QUALIFICATIONS :

• Bachelor’s Degree in Information Systems, Health Informatics, Business Analytics, Mathematics, Healthcare Management, Health Services Research, Public Health, or other related field
• 5+ years’ experience conducting data analytics using tools such as SQL, SAS, Tableau, etc.
• Highly proficient in Microsoft Office Excel; experience creating complex formulas, using conditional formatting, and creating Pivot Tables
• Proficient in Microsoft Office Word, PowerPoint, and Tableau
• Working knowledge of SQL, SAS, Crystal, or similar query or data manipulation tools
• Ability to manage multiple projects or assignments simultaneously within expected time constraints and with minimal supervision
• Experience presenting data or reporting used to inform meaningful decision making
• Experience making day to day decisions using sound judgment with minimal guidance
• Ability to interpret detailed, written technical specifications and apply them to business operations
• Demonstrated ability to learn and utilize new complex computer software and applications
• Strong diagnostic skills to troubleshoot and resolve data and reporting technical issues
• Experience working with and generating insights from large data sets
• Good oral, written, and interpersonal communication skills
• High level of integrity and quality of performed work

PREFERRED QUALIFICATIONS

• Master’s degree in a related field
• Experience in healthcare analytics working with standard healthcare quality measures
• Experience with analytics using advanced statistical methodologies
• Six Sigma Green Belt or greater
• Knowledge of national standard healthcare quality metrics such as CMS Star Ratings, CMS Core Measures, HEDIS, Risk Adjustment, Medical Coding, etc.
• Knowledge of Medicare Advantage, Health Maintenance Organizations, and/or other Health Insurance operations
• Capability to independently identify and evaluate opportunities for improvement related to Key Performance Indicators
• Demonstrated knowledge of statistical analysis techniques as well as data visualization practices
• Knowledge of data organization principles and techniques (ex: data tables databases, data storage, and retrieval)
• Highly Proficient Tableau knowledge and experience
• Intermediate SQL knowledge and experience