Quality Improvement Data Analyst
TennCare is Tennessee’s managed care Medicaid program that provides health insurance coverage to certain groups of low-income individuals such as pregnant women, children, caretaker relatives of young children, older adults, and adults with physical disabilities. TennCare provides coverage for approximately 1.4 million Tennesseans and operates with an annual budget of approximately $12 billion. It is run by the Division of TennCare with oversight and some funding from the Centers for Medicare and Medicaid Services (CMS).
WHY WORK AT TENNCARE?
TennCare’s mission is to improve the lives of Tennesseans by providing high-quality cost-effective care. To fulfill that purpose, we equip each employee for active participation and empower teams to communicate and work collaboratively to improve organizational processes in order to make a difference in the lives our members. Because of the positive impact TennCare has on the lives of the most vulnerable Tennesseans, TennCare employees report that their work provides them with a sense of meaning, purpose, and accomplishment. TennCare leadership understands that employees are our most valuable resource and ensures professional and leadership development are a priority for the agency.
JOB AND DEPARTMENTAL OVERVIEW
Operationally, the Quality Improvement (QI) Division works closely with several other TennCare divisions to lead development and execution of a comprehensive quality strategy. Additionally, the QI team plays a strategic role in TennCare initiatives focused on improving clinical care and outcomes for TennCare members, including primary care transformation and population health. Externally, the QI division works closely with TennCare’s contracted organizations and other state agencies to provide oversight of quality performance and data reporting for TennCare Members. This position will be a key member on the QI Data Analytics team reporting to the QI Data Analytics Director.
• Utilize data and analytic tools to meet quality reporting requirements and provide insights for clinical quality improvement
o Query, collect, prepare, and safeguard data and produce key deliverables to satisfy CMS, legislative, and other ad-hoc requests for data and information
o Provide analytics expertise to review and summarize complex reports for the QI team and others upon request.
o Evaluate quality measures at the individual provider or aggregate level using relevant information, individual judgment, National Committee of Quality Assurance (NCQA), and CMS specifications.
o Utilize knowledge of claims data to identify key trends and data insights to inform CMO leadership decisions on key clinical areas and clinical outcomes. Key topics include social determinants of health, maternal health, behavioral health, and health disparities
o Participate in designing and developing a QI Dashboard highlighting projects and initiatives within the Quality Improvement department.
• Consult with other teams within the Chief Medical Office (CMO) on the design and development of dashboards and other visualizations
o Participate and lead design meetings with other CMO teams (Pharmacy, Dental, Appeals, etc.) to assist with designing and developing various dashboards using Tableau
o Develop performance dashboards in Tableau, lead training, and provide ongoing support to CMO teams to ensure the sustainability of dashboards
o Develop an organizational structure for data visualization and dashboarding across all CMO data and performance dashboards
o Utilize data visualization skills to create infographics and dashboard designs that inform medical policy decisions and quality improvement strategic planning
• Partner with clinical data lead to support the development of TennCare Quality Strategy:
o Present relevant reporting information or quality data, both formally and informally, to small and large groups.
o Create presentation-ready deliverables for internal and external stakeholders.
o Support QI and CMO leadership in quality strategy development.
o Manage special projects assigned by QI Division Director.
• Example projects could include:
o HEIDS quality measure analysis
o Opioid usage analysis
o Maternal health analysis
o Other disease-specific analysis
• Use TennCare data to explore and identify emerging areas that require clinical focus
• Provide analytical support for Population Health, Primary Care Quality and Patient-Centered Medical Home (PCMH) teams:
o Combine and integrate data from multiple sources to assess program performance and progress.
o Train business users to understand and utilize final analytics deliverables.
o Assist in developing quality metrics and templates for quarterly and annual reporting in the population health program
o design and create dashboards for the population health and PCMH teams that highlight program successes and areas for improvement
o design and entire involved cost and outcome projections for PCMH, Population Health, and Medication Assisted Treatment programs
• A Master’s Degree in statistics, applied statistics, social or behavioral sciences, health sciences, business, business administration, or public policy and 2+ years full-time professional work developing research methodology and/or directing statistical research OR
• A Bachelor’s Degree in statistics, applied statistics, social or behavioral sciences, health sciences, business, business administration, or public policy and 5+ years full-time professional work developing research methodology and/or directing statistical research
• 2+ years of statistical and analytical experience using SAS and/or SQL.
• Strong computer skills, including mastery of Microsoft (Excel, Access, Word, and PowerPoint) and statistical software applications (SAS, R, Python, etc.)
• Strong, clear, and concise oral and written communication skills
• Strong organizational skills, including the ability to prioritize, multi-task, and manage workload to meet specific timeframes and deadlines.
• Experience in Tableau
To see all the great benefits available to State of Tennessee employees, go to the TN.gov Benefits page: https://www.tn.gov/hr/employees1/benefits.html
How to Apply
To apply for this job or see other opportunities at TennCare, visit the state of Tennessee’s Careers page today: https://www.tn.gov/careers/apply-here.html
- Date Posted: March 18, 2021
- Type: Full-Time
- Job Function: Administrative
- Service Area: Government