Hcq Quality Program Analyst

5 days ago

Jakarta, Indonesia Agilon Health Full time

Company:
MDX Hawai'i, Inc.

**Location**:
Remote - HI

Job Title:
HCQ Quality Program Analyst

**Job Description**:
Position Summary:
This position will have the opportunity and responsibility to create project plans as well as collaborate with many other resources to improve processes. This role will be responsible to research opportunities for improvement. Tools utilized will include the electronic and paper health record, claims system, clinical informatics reports, national guidelines, NCQA standards, HEDIS specifications, CMS regulations and other applicable resources.

Essential Job Functions:

- Conducts, studies and analyzes the data and spreadsheets from both Health Plans to evaluate MDX Hawaii’s HEDIS measures, with duties including performing computer-based statistical analysis of data related to the Quality Improvement (QI) program, monitoring and ensuring the validity of data, evaluating reports for accuracy of data, and performing analysis to determine statistically significant trends in the data compared to industry standards and recognized benchmarks.
- Creates process documentation for Star Rating and Quality program activities;
- Analyzes, develops and implements improvement activities to increase compliance rates as measured by nationally standardized benchmarks and definitions that includes identifying preventive care areas with declining or plateauing compliance rates over time including root cause analysis for contributing factors, developing and implementing provider level report cards, educational programs and outreach strategies for providers and members to facilitate compliance and competency with HEDIS guidelines;
- Working with report writers to validate and troubleshoot data in HCC manager, Axis and any other systems.
- Working with provider offices directly to increase compliance rates and practice improvement
- Assists with HEDIS reporting with duties including coordinating and submitting samples to the health plan to ensure quality data, maintaining HEDIS member exclusion data, and working with supplemental data sources such as immunization registries and lab vendors.
- Presents updates and summaries to executive leadership, staff, and other audiences as required.
- Works closely with the Medical Director and other team members to plan and develop clinical quality improvement projects and member and provider engagement activities.
- Integrates Stars activities with HCC risk adjustment initiatives to optimize care improvement opportunities with revenue management.
- Conducts coaching and training as appropriate for physicians, NPs, and other staff to improve the quality of the documentation, collection and coding of members’ health data.
- Performs other duties, as assigned.

Required Qualifications:
Minimum Experience:

- Five years in managed healthcare field or academic equivalent.
- Requires experience with quality improvement, requirements, and regulations or related fields (i.e., NCQA, Medicare, Medicaid, etc.).
- Familiarity with EMR systems or chart reviews preferred.
- Willingness to take full ownership for program success and instill accountability in cross functional teams to achieve corporate goals.

Education/Licensure:

- High School Graduate Required.
- Bachelor of health sciences or medical preferred.
- Current valid Hawai’i State Driver’s License and Proof of Hawaii No-Fault Auto Insurance. Clean driving record as evidenced by a recent driver’s abstract (to be provided by employee).

  • Trainer & Program Designer

    1 week ago

    Gambir, Jakarta, Indonesia Service Quality Centre Indonesia SQC Indonesia Full time 60,000,000 - 120,000,000 per year

    PT Service Quality Centre Indonesiais a leading training and consulting firm specializing in service quality, quality management, human resource development, and organizational transformation. Established in 1993, the company partners with businesses across industries to enhance customer experience, operational performance, and leadership capability. With a...

  • System Analyst Programming

    2 weeks ago

    Jakarta, Indonesia PT Adi Data Informatika Full time

    Pendidikan mínimal S1, diutamakan jurusan Teknologi Informasi (Teknik Informatika, Ilmu Komputer, Manajemen Informatika, Teknik Komputer dan sejenisnya) - Memiliki pengalaman sebagai system analyst pada pengembangan aplikasi - Lebih diutamakan pengalaman sebagai programmer d. Memahami bahasa pemrograman (Java/dot net) dan database (oracle/ms. SQL) -...

  • Sr. Programming Analyst

    3 days ago

    Jakarta, Indonesia PT. BSR Indonesia (MNC Group) Full time

    **Requirements**: - Bachelor's Degree in Computer Science/Information Technology major - Have at least 2 years of experience as Software Developer/Programmer Analyst in: PHP, Laravel framework - Having knowledge in flutter programming is a plus - Having knowledge in Mobile App Development is a plus - Preferably have experience as full stack developer -...

  • Air Quality and Climate Research Analyst

    3 days ago

    Jakarta, Indonesia WRI Indonesia Full time

    **Program Overview** - WRI’s air quality program is a global initiative that seeks to identify, build awareness of, and eliminate the root causes of air pollution that damages climate, human, and ecosystem health. The program has three main areas of work: (i) engagement with city stakeholders to use participatory science to diagnose and develop targeted,...

  • Quality Assurance Analyst

    1 week ago

    Jakarta, Jakarta, Indonesia Sekolah Full time 10,000,000 - 20,000,000 per year

    Job DescriptionPlan and define development and testing priorities for each sprint.Create, review, and maintain detailed test cases.Conduct pair testing with the development team.Perform testing on new features and improvements.Ensure all assigned tasks have been properly tested before release.Identify and document as many defects as possible, with a focus on...

  • Quality Assurance Analyst

    1 week ago

    Jakarta, Jakarta, Indonesia PT Karya Solusi Prima Sejahtera Full time 9,000,000 - 12,000,000 per year

    Pendidikan minimal S1, diutamakan jurusan Teknologi Informasi (Teknik Informatika, Ilmu Komputer, Manajemen Informatika, Teknik Komputer, Sistem Informasi, dan sejenisnya).Memahami konsep, prinsip, metodologi dan best practice terkait pengujian, baik waterfall, agile, maupun pengembangan secara Commercial Off-The-Shelf (COTS).Memahami proses quality...

  • Lead Quality Assurance Analyst

    1 week ago

    Gambir, Jakarta, Indonesia Workmaze Full time 24,000,000 - 42,000,000 per year

    Company DescriptionWe suggest you enter details here.Role DescriptionThis is a full-time on-site role for a Lead Quality Assurance Analyst, based in Gambir. The Lead Quality Assurance Analyst will oversee quality assurance processes, ensuring the functionality and performance of products meet established guidelines. Responsibilities include developing and...

  • System Analyst

    5 days ago

    Jakarta, Indonesia Demolytic Full time

    **Jakarta**: **Indonesia**: We are looking for a System analyst to implement and improve our IT systems. You will analyze system requirements and address any relevant problems. You will also perform standard testings and provide solutions to ensure high levels of performance and security. As a system analyst, you will be joining a team of engineers and...

  • Icitap Central Asia Program Analyst

    3 days ago

    Jakarta, Indonesia Amentum Full time

    Amentum is a premier global services partner supporting critical programs of national significance across defense, security, intelligence, energy, and environment. Amentum draws from a century-old heritage of operational excellence, mission focus, and successful execution underpinned by a strong culture of safety and ethics. Headquartered in Chantilly, VA.,...

  • Analyst

    3 days ago

    Jakarta, Indonesia Palladium Group, Inc. Full time

    **Analyst** **About Palladium** Palladium is a global leader in the design, development, and delivery of Positive Impact - the intentional creation of enduring social, climate and economic value. We work with governments, businesses, and investors to help solve the world's most pressing challenges. With a team of more than 2,000 employees operating in...