Manager, Quality Data

Job Category:  Management/Executive
Department:  Quality Performance Management (655)
Location: 

Los Angeles HQ, California, US

Position Type:  Full Time
Requisition ID:  1482

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members in five health plans, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

DUTIES

The Manager of Quality Data is an important role on a the quality data team. This position who will works closely with technical, clinical, and compliance personnel to assure accurate and timely delivery of HEDIS and Survey data to regulatory entities, partners and other stakeholders. The Manager, HOA Quality Data Manager plays a key role in optimizing data procurement and streamlining operational processes for ETL. This manager position is responsible for the performance of the HEDIS data analysts which includes Lead Analyst, Sr. Data Analyst, other Data Analysts and Survey Analysts. This position is responsible for data process regarding HEDIS and Surveys, including Member and Provider experience, Health Outcomes and others which together are used for NCQA accreditation and L.A. Care provider, group and plan partner performance management. These are high profile projects for L.A. Care and it's CEO. This position will creates and maintains policies and procedures relevant to the HEDIS and Survey data process involving rate calculations and reports and quality assurance checkpoints which may involve other L.A. Care teams. This position in this role will also coordinates with vendors, provider groups and plan partners to maximize data completeness, analyzing quality data results to identify improvement opportunities. In addition to these responsibilities, this position works with product evaluation, reviews and manages the budget, accounts for variations, works with the legal advisor on review and vetting of proposals and contracts, participates in compliance audits such as HEDIS, NCQA and others as needed and will contribute to executive summary documentation and presentations on outcomes. The Manager participates in Quality Improvement initiatives and committee meetings. The Manager in this role will have a pivotal role in the success of L.A Care as public reporting and data process efficiency are of utmost importance.

QUALIFICATIONS AND REQUIREMENTS

EDUCATION

Required:

High School Diploma

Preferred:

Associate's or Bachelor's Degree Biostatistics Epidemiology, Mathematics, Economics, Computer Science, Health Science, Quantitative Social Sciences, Statistics, Information Systems, or related fields.

LICENSES/CERTIFICATIONS

Preferred:

Certified HEDIS auditor, RN, LN, RHIA, RHIT, or certification from a nationally recognized Quality Improvement or Project Management program.

EXPERIENCE

Required:

With High School Diploma: 12 years of clinical outcomes review and quality data experience with strong skills in data validation, and with at least 3 years of HEDIS and Surveys (for example, CAHPS, CG-CAHPS, CAHPS- MAPD, QHP-EES, HOS, etc.) experience; and with 3-5 years of supervisory/management experience.

Preferred:

With Associate's Degree: 9 years of clinical outcomes review and quality data experience with strong skills in data validation, and with at least 3 years of HEDIS and Surveys (for example, CAHPS, CG-CAHPS, CAHPS- MAPD, QHP-EES, HOS, etc.) experience; and with 3-5 years of supervisory/management experience.

With Bachelor's Degree: 6-8 years of clinical outcomes review and quality data experience with strong skills in data validation, and with at least 3 years of HEDIS and Surveys (for example, CAHPS, CG-CAHPS, CAHPS- MAPD, QHP-EES, HOS, etc.) experience; and with 3-5 years of supervisory/management experience.

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)


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