Business Analyst Quality Improvement Specialist

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Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.

Summary

As a Business Analyst Quality Improvement Specialist at Gainwell, you’ll be part of a highly collaborative team that is responsible for continuous quality improvement to Gainwell Pharmacy Benefit Manager services in Ohio.

We define, implement, and evaluate data-driven strategies to achieve high quality outcomes for populations served by the Ohio Department of Medicaid (ODM) Single Pharmacy Benefits Manager (SPBM).

We’re seeking a creative problem solver and team player who uses strong communication and problem-solving skills to contribute to our day-to-day quality improvement activities.

You will be able to apply an intermediate level of subject matter knowledge to solve a variety of healthcare access and quality improvement from a pharmacy perspective.

You'll work on problems of moderately complex scope. Acting as an informed team member providing analysis of information and facilitates project groups.

Exercising independent judgment within defined practices and procedures to determine appropriate action. Following established guidelines and interprets policies.

Evaluating unique circumstances and making recommendations.

You'll facilitate quality improvement projects with oversight of the Ohio Department of Medicaid (ODM), to improve quality measures related to the PSBM pharmacy benefit.

This will include being a resource for project vetting, organizing project timelines, scheduling and documentation, leading meetings and ensuring all steps through the PDSA Milestones are accomplished.

Here are the details on this position.

Your role in our mission

• Facilitate Quality Improvement Projects following PDSA methodology from start to finish
• Be a resource for all departments to analyze potential quality improvement projects, assist with development and

implementation.

Assists in analyzing and documenting quality improvement opportunities, including planning data needs,

team building and root cause analysis.

Assist in the PDSA cycle to ensure IHI Model for Improvement methodology is followed through the Milestones from

planning to sustaining

• Assists in maintaining documentation and files, building presentations and keeping projects organized
• Professionally engage and participate in meetings with clients and Managed Care Entities in collaboration projects,

report-outs and as a subject matter expert.

Participates in meetings as an active voice representing quality improvement projects, successes and

lessons learned

Leads project meetings, planning meetings and follow-up meetings to ensure clear communication and

expectations are met

Participates in group activities to build and organize project plans, timelines and team meetings

What we're looking for

• 3-5 years Quality Improvement experience working with the interface of information technology with functional groups within an organization
• Bachelor's degree in business or healthcare management discipline is preferred
• Requirements determination using structured techniques for documentation, analysis, evaluation / validation
• Decomposition of high-level information into details
• The Ability to Distinguish between :

Requests vs Needs and Requirements vs Solutions

• Classifying and prioritizing requirements
• Applying creativity to solving complex problems
• Building relationships and working collaboratively
• Effective Verbal and Written Communication

Essential qualities

• MS Office - Word, Excel, PowerPoint, SharePoint, Teams
• SME in Quality Improvement, Methodologies
• Strong Analytical and Problem-Solving Skills
• Experience leading and facilitating Quality Improvement projects following PDSA methodology.
• Experience with Managed Care Entities, Pharmacy Benefit Manager, care coordination, or Medicaid and Medicare state regulators is beneficial to this role.
• Strong communication skills, public speaking and group engagement . Experience presenting complex processes to stakeholders and incorporating feedback into process improvement.

Creative, out-of-the-box thinking, self-motivated, ability to work independently, as well as a solid team player, with a positive attitude, in a dynamic work environment

Approachable and professional in all interactions and demonstrates uncompromising integrity and absolute accountability

Preferred skills

• Familiarity with Lean Six Sigma methodology, continuous process improvement and rapid-cycle improvement a plus
• Experience with Project and change management tools such as Visio
• Healthcare Experience

What you should expect in this role

• Fully remote options from Continental US locations only
• Ability to work 8-5a, Eastern Standard Time
• Video cameras must be used during all interviews, as well as during the initial week of orientation

The deadline to submit applications for this posting is October 8, 2024

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The pay range for this position is $55,600.00 - $79,400.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors.

Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development.

All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance.

We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone.

Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth.

Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.

We celebrate diversity and are dedicated to creating an inclusive environment for all employees.