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Senior Quality Improvement Analyst Job Details

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Company:  WellCare Health Plans, Inc.
Job Code:  1100174
Categories:  For-Profit Senior Services
Job Role:  LPN / LVN / Nurse
Region/Province:  Florida (FL)
City:  FL-Tampa
Job Description:  !*!About WellCare: WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. For more information about WellCare, please visit the Company's website at www.wellcare.com.

Our History: Founded in 1985 with three associates, WellCare grew to more than 800 associates and 467,000 members in Florida, New York and Connecticut by 2002. In 2004, the company acquired Harmony to enter the Midwest and became publicly traded. By 2006, WellCare served 2.2 million members as it became a national prescription drug plan provider and the largest Medicaid plan in Georgia. WellCare expanded its services when it began offering Medicaid managed care plans in Ohio and Missouri in 2007, and Medicare managed care plans in Texas and New Jersey in 2008. Additional growth followed when the company was chosen to serve Hawaii's Medicaid program for the aged, blind or disabled in 2009, and in 2011 when it was selected to serve Kentucky's Medicaid program. Today, WellCare has more than 3,900 associates and approximately 2.4 million members nationwide.

EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.

Coordinates complex assignments involving cross functional teams in the fulfillment of contract deliverables, regulatory and accreditation requirements with focus on data analytics and performance improvement. Models and promotes the core values of the Collaborative and WellCare. Provides data analytics assistance to all levels within Quality Improvement at both a market and corporate level.

 

Essential Functions:


  • Defines analysis methodology and provides analytic support to QI staff

  • Maintains databases and reports specific to QI functions and regulatory and accreditation requirements

  • Collaborates with other teammates to deliver solid, effective solutions

  • Provides data for select performance measures to regional offices

  • Communicates with external data sources as needed to gather data necessary to measure identified outcomes

  • Prepares ad hoc reports as needed for QI management

  • Identifies, evaluates and implements new data-driven strategies and processes for the organization.

  • Develops tools and reports that lend valuable insights that capitalize on a combination of internal and external data.  

  • Recommends enhancements to existing systems in accordance to business needs by creating ad hoc and standard reports as well as new information delivery technologies

  • Acts as point of contact for business users providing both tool support and data expertise

  • Develops and provides insights into streamlining analytic QI processes.

  • Manages HEDIS reporting and analytics

  • Prepares reports and quality improvement studies in an accurate, concise and timely fashion

  • Coordinates centralized and market work plans and actions with team members assuring project timeliness and expectations are met

  • Manages key project initiatives associated with delegated vendor functions, monitoring and summarizing vendor oversight project progress.

  • Participates in cross functional internal and external quality teams to improve overall organization performance

  • Performs data collection, analysis, reporting and presentation of quality improvement activities.

  • Performs other duties as assigned.


Education:  A Bachelor's Degree in Public Health, Epidemiolog, or other related health field required.  A Master's Degree preferred.                                                         

 

Experience:  5 years of experience in collecting, analyzing, and presenting data and recommendations to management required. Knowledge of quality improvement philosophy and techniques desirable. Experience in mainframe applications and/or statistical applications.   

 

Licenses/Certifications:  HEDIS Auditor is desired. Certified Professional in HealthCare Quality is desired. Managed Healthcare Professional is desired.                                      

 

Special Skills (e.g. 2nd language): 

Excellent communication skills

Ability to communicate effectively with people with varying levels of education

Ability to provide draw conclusions from data analysis

Ability to multitask in a fast paced environment

 

Technical Skills/Requirements:  Proficient in Microsoft Office such as Word, Excel, PowerPoint, Access and Outlook.  Ability to utilize other data management systems to pull and analyze information to draw conclusions and recommendations. 
Post Date:  01/29/2012

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