Quality Improvement Data Analyst

TennCare

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Job Summary

TENNCARE OVERVIEW

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 Responsibilities

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 focuses 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.

RESPONSIBILITIES

• Utilize data and analytic tools to meet quality reporting requirements and provide insights for clinical quality improvement:
  • Query, collect, prepare, and safeguard data, and produce key deliverables to satisfy CMS, legislative, and other ad-hoc requests for data and information.
  • Design and complete complex cost and outcome projections for various QI programs (such as PCMH [Patient Centered Medical Home] and Population Health).
  • Provide analytics expertise to review and summarize complex reports for the QI team and others upon request.
  • Evaluate quality measures at the individual provider or aggregate level using relevant information, individual judgement, and National Committee of Quality Assurance (NCQA) and CMS specifications
  • Coordinate and support submission of yearly reporting metrics, such as CMS 4-16 EPSDT (Early and Periodic Screening, Diagnostic, and Treatment) rates and CMS Adult and Child Core Set Measures.
  • Utilize knowledge of claims data to inform decisions about measures and technical specification design and implementation.
  • Partner with QI and other TennCare stakeholders on analyzing impact of social determinants of health on health outcomes.
  • Support clinical leadership to measure and improve maternal and infant health outcomes.
  • Lead analysis to identify and address potential health disparities for subpopulations of TennCare members.
  • Participate in the design and development of a QI Dashboard highlighting projects and initiatives within the Quality Improvement department.
• Partner with clinical data lead to support QI leadership in development of TennCare Quality Strategy:
  • Present relevant reporting information or quality data, both formally and informally, to small and large groups.
  • Create presentation-ready deliverables for internal and external stakeholders.
  • Support QI and Medical Office leadership in quality strategy development.
  • Manage special projects assigned by QI Division Director. Types of projects could include HEIDS analysis, opioid usage analysis, maternal health analysis, and other disease specific analysis.
• Provide analytical support for Population Health, Primary Care Quality and PCMH teams:
  • Combine and integrate data from multiple sources to assess program performance and progress.
  • Train business users to become knowledgeable of and comfortable with final analytics deliverables.
  • Assist in the development of quality metrics and templates for quarterly and annual reporting.
  • Design and develop dashboards for the population health and PCMH teams that highlight program successes and areas for improvement.

Qualifications

MINIMUM QUALIFICATIONS

• 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) as well as statistical software applications (R, SAS, 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.

DESIRABLE QUALIFICATIONS

• Experience in Tableau or related data visualization software
• Experience in healthcare field and/or with quality measurement
• Experience in survey development and analysis

Additional Information

Benefits

How to Apply

Please go to https://www.tn.gov/careers/apply-here.html to apply for this job today.

Details

• Date Posted: March 19, 2020
• Type: Full-Time
• Job Function: Analytics / Evaluation
• Service Area: Government