Quality Analytics Director

The Director of Quality Analytics leads complex analytics projects and initiatives to help guide clinical and operational business leaders achieve strategic goals. Partner with internal business units to identify and develop opportunities in quality and disease management. Responsible for the measurement and reporting of clinical and quality programs.

Primary Responsibilities:

– Collaborate with all departments, including Finance, Operations & Clinical from a strategic perspective to identify and maximize opportunities to utilize data to improve clinical outcomes, business processes, promote the strategic use of information, and enable the workforce to use data analysis and interpretation as a competitive tool.
– Support efforts to attain and maintain excellent NCQA accreditation status, achievement of health outcome targets and reduction in administrative costs
– Oversee the review and analysis of reports
– Drive innovation and advancement in quality analytics, health outcomes and HEDIS management
– Develop and implement plans and objectives for the department in an effective and innovative fashion
– Oversee and coordinate daily operations
– Assess and report progress in meeting department objectives
– Manage department staffing needs (e.g. interviewing, hiring, new hire and ongoing training, annual evaluations, etc.)

Knowledge, Skills & Abilities:

– Knowledge of medical terminology and coding, HMO concepts, practices and procedures, as well as financial concepts and statistical analysis.
– Advanced technical skills in computer programming, database concepts, statistics and ad hoc query tools (i.e. SQL, SAS, MS Access, Excel, etc.) as well as design expertise in visual analytics.
– Must be able to meet deadlines, juggle multiple projects and work independently.
– Knowledge of healthcare analytics
– Aptitude in telling the story behind the data and translating analysis into insights and recommendations
– Familiarity with medical coding, utilization trends and healthcare finance.
– Strong analytical skills and business problem-solving skills.
– HEDIS reporting experience
– Expertise with SQL, SAS, PowerBI, Excel, Access, Visio or other report databases
– Excellent communication, planning, and organizational skills
– Executive presence with excellent written and oral communication skills

Education and Experience:

– Bachelor’s Degree required; Master’s in Finance, Business or Healthcare Administration preferred.
– 7 years of experience in business performance reporting, data analysis and proactive insights.
– Managed Care and Medical claims experience preferred.
– 3 years of directly leading and managing teams.

Valid Driver’s License Required: No

Travel Type: None Required

Equal Opportunity Employer/ Protected Veteran/ Individuals with Disabilities

Cardinal Innovations is firmly committed to the policy of providing equal employment opportunity (EEO) to all of its employees and applicants for employment without regard to race, age, color, sex, religion, creed, veteran status, genetic information, national origin, non-job related disability, sexual orientation, and/or gender identity or expression (except as mandated by law). Employment at Cardinal is based solely on a person’s merit and qualifications directly related to professional competence. For that reason, we consider qualified applicants regardless of criminal histories, consistent with legal requirements. Our equal employment opportunity philosophy complies with federal, state and local law and applies to all aspects of employment with Cardinal, including recruiting, hiring, training, transfer/promotion, compensation, benefits and termination.

If you have a disability or special need that requires accommodation, please let us know by contacting Cardinal’s Human Resources department at HumanResources@cardinalinnovations.org Someone from the HR team will reach out to see how we may be able to assist.

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