Director, Quality and Clinical Analytics and Reporting

Schenectady, NY - Posted: 12/20/17 | SHARE:


MVP Health Care is a nationally-recognized, regional not-for- profit health plan. We are committed to having a positive impact on the health and wellness of everyone and every community we serve. We care for more than 700,000 members across New York and Vermont, and we are powered by the ideas and energy of more than 1,600 employees – providing a wide range of health benefit plan options with attentive service and flexibility normally associated with a smaller company. Stop settling for “just a job,” and join a company where you can reach your full potential…and make a positive difference!

JOB TITLE: Director, Quality and Clinical Analytics and Reporting (Job ID: 1111)
STATUS: Full time, Exempt
LOCATION: Schenectady

The Director of Quality and Clinical Analytics Reporting will be responsible for providing data and information to the clinical management and provider relations teams of MVP. Participate in dialogue with internal teams and external partners to identify and select relevant clinical and administrative data elements to share with and acquire from provider partners in value-based agreements. Design analytical and reporting packages for provider partner access. Direct internal operations to assure the timely and effective completion of necessary analysis and reporting. Evaluate and interpret analytic output, guiding refinements to approaches to meet the needs of individual contractual situations. Lead the education of internal staff and external provider partners on use of analytical and reporting tools and the data within those tools. Oversee the production of accurate and appropriate presentation materials to inform value-based contract deliberations. Collaborate with internal and external partners to present and deliberate over analytic output in the context of individual contract negotiations. Lead internal efforts to maximize and monitor the efficiency and quality of analytic processes supporting all value-based contracting. Provide the analytic lead for quality measurement including reporting for Healthcare Effectiveness Data and Information Set (HEDIS) and New York State’s Quality Assurance Reporting Requirements (QARR). Collaborate with leadership of other departments to select, implement, integrate, and utilize necessary software solutions. Assure timely and effective completion of serial and ad hoc reporting needs to support the company’s full array of value-based contracts and initiatives


Minimum Education:
Bachelor’s degree required. Master’s degree in healthcare area (e.g. health administration, public health) or licensed
healthcare professional preferred (e.g. pharmacist, nurse).

Minimum Experience:
Five or more years of experience working with clinical data (electronic health records), healthcare claims, or provider quality measures, preferably for a health plan, consulting firm, provider group, health system or a software vendor that offers data solutions to health systems or providers.
Five or more years of experience managing staff with analytical skills sets

Required Skills:
• Knowledge of administrative datasets (i.e. claims, eligibility, etc.) reporting /analytic uses (e.g. cost and utilization reporting, disease management, etc.) and terminology (e.g. PMPM, and per 1000 measures, diagnosis/procedure codes, episode groupers, risk adjustment, etc.)

• Understanding and experience with the Healthcare Effectiveness Data and Information Set (HEDIS) and
New York State’s Quality Assurance Reporting Requirements (QARR).
• Strong understanding of relational databases and data management processes
• Superior problem solving, analytic skills and an ability to analyze large volumes of data and identify
trends and anomalies
• Ability to work independently, as well as work effectively as a member of a team
• Proficient in personal presentation, verbal, and written communication
• Ability to prioritize multiple assignments with attention to details and deadlines in a high volume
• Must be self-motivated, proactive and able to work well under pressure.

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