Performance Improvement Analyst (Remote - NC)

LOCATION : Remote this is a virtual, home-based position. Incumbent must live in North Carolina or within 40 miles of the NC border.

GENERAL STATEMENT OF JOB

The Performance Improvement Analyst will provide administrative and operational support for Care Management with a focus on quality improvement, process improvement, data, and performance reporting.

Structure, collect, compile, and analyze data and reports in order to support Care Management operational standards and metrics.

Utilize data and reports to assess for overall quality, program effectiveness, and outcomes for members. Provide insight and recommendations in order to continually improve Care Management operations.

ESSENTIAL JOB FUNCTIONS

Operational Support :

• Collects and summarizes performance data, identifies opportunities for improvement, and presents findings
• Analyzes current workflows and standards against performance data in order to assess for process adherence and makes recommendations for improvement
• Improve quality and operational effectiveness by developing strategies and recommendations from findings associated with member record reviews, audits, spreadsheets, and surveys
• Create and maintain Care Management performance improvement initiatives required to meet national accreditation or regulatory performance improvement initiatives
• Develop / edit / maintain report job aids and deliver training and coaching on existing and newly developed reports
• Run and report out on process adherence reports.
• Communicate positively and energetically and is the day-to-day central receiver of feedback and questions about reports from CM staff.
• Assist with the development, maintenance, and reporting of Leadership Dashboards ensuring information is provided to CM Directors and VP monthly

Collaboration :

• Support ongoing performance measures by initiating measurable process improvement opportunities within Care Management and collaborating with department leads
• Partners with CM Leadership to instill a Continuous Improvement culture
• Work with CM Managers and Dept leadership to understand report content; Partner with CM Leadership and other departments as needed to support the Population Health and Care Management data and outcomes strategy.
• Work closely with CM Program Data Manager, Population Health Data Managers and Business Analysts to identify and address barriers in technical CM processes and documentation.
• Participate in organizational committees and work groups related to CM data and quality.
• Work with Subject Matter Experts & CM Program Data Manager to develop drafts of workflow standards and measurable performance metrics.

Report Development :

• Ensure operational reports are well developed and put into use in a timely way.
• Organize and work with others to submit any report modification or enhancements to Management Information Services.
• Work with Process Oversight work groups to test new prototype reports, incorporate / address feedback.
• Support User Acceptance Testing strategies and execution plans

Other Duties Assigned.

KNOWLEDGE, SKILL & ABILITIES

• Knowledge, understanding, and application of principles related to Quality Improvement, Process Improvement, Lean Methodologies, and Performance Reporting
• Establish and use quality metrics to drive change and deliver measured improvements
• Knowledge of the business processes and workflows of the different teams within the Care Management department
• Knowledge and understanding of Managed Care Organizations and contract requirements with the Department of Health and Human Services.
• Skilled in Excel with very strong skills including but not limited to filtering, formulas, creation of charts and graphs, and pivot tables.
• Skilled in data literacy and understanding of basic terms and concepts as well as experience creating and applying (i.

e., understands measures, metrics, key performance indicators, outcomes, numerators, and denominators; can create rates, averages, percentages, frequencies, etc.).

• Computer proficiency in e-mail, Microsoft suite applications i.e. Excel, Word, Process Mapping, PowerPoint, Power BI
• Participate in and maintain Care Management and Vaya trainings and proficiencies.
• Exceptional interpersonal skills, highly effective communication ability, and the propensity to make prompt independent decisions based upon relevant facts.
• Excellent verbal and written skills.
• Detail oriented, able to organize multiple tasks and priorities, and to effectively manage projects from start to finish.
• Ability to demonstrate flexibility and adaptability based on changing priorities and improvement of processes
• Ability to exercise balanced judgment in evaluating situations and making decisions, and to handle difficult or confrontational situations in a calm, consistent manner
• Organized, strong detail orientation, methodological, motivated and demonstrates good follow through.

EDUCATION & EXPERIENCE REQUIREMENTS

Bachelor’s degree in sociology, psychology, or related field, including coursework in statistics, research methodology, computer science, continuous improvement and / or other coursework directly related to the work to be performed.

• Two (2) years of experience gathering, editing, and analyzing data; or an equivalent combination of education and experience.
• Two (2) years of experience in the field of quality management / continuous quality improvement preferred.

Preferred Licensure / Certification :

Lean, Six Sigma, Project Management, or related certification is preferred.

PHYSICAL REQUIREMENTS

• Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.
• Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists and fingers.
• Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.
• Mental concentration is required in all aspects of work.

RESIDENCY REQUIREMENT : The person in this position is required to reside in North Carolina or within 40 miles of the North Carolina border.

SALARY : Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.