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Planning and Operations Specialist, Senior - Provider Network
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$102k–$125k/yr
Full-time
bachelor degree, postgraduate degree
Medical insurance, Dental insurance, Vision insurance, Life insurance, AD&D insurance, Disability insurance
Posted 1d ago
~40 hrs/week
Remote in Portland, Oregon, United States
Responsibilities
This position leads data analysis and visualization efforts to meet clinical performance metrics and regulatory deliverables. It also involves mentoring less experienced analysts and providing strategic recommendations to leadership.
Requirements
Candidates must have at least 6 years of experience in quality improvement or population health, including 4 years of data analytics experience. Alternatively, a bachelor's or master's degree in a relevant field with corresponding years of experience is required.
This position performs data analysis and data visualization at a lead level. Essential responsibilities are aligned with practices and teams within a defined geographic area, coordinated care organization (CCO), benefit or line of business and providing guidance to less experienced analysts. This position spends substantial time using a combination of evaluation, quality improvement methods, data analysis, and data visualization to meet defined clinical performance metrics, and regulatory deliverables. This position integrates quality improvement QI activities, processes, and projects with the CareOregon Quality Strategy and related regulatory and accreditation standards to promote compliance. Additionally, this position is responsible for leading people and projects.
Estimated Hiring Range:
$102,330.00 - $125,070.00
Bonus Target:
Bonus - SIP Target, 5% Annual
Current CareOregon Employees: Please use the internal Workday site to submit an application for this job.
Perform ongoing synthesis and analysis of performance information.
Conduct moderate to complex analysis of key metrics and program data to identify trends, make predictions, and calculate targets.
Leads the development of dashboards to provide visual assessment of metric performance and regulatory compliance.
Using quality improvement and evaluation technical skills, evaluate line of business/regional priorities and develop strategic reporting systems for use at the staff, program manager, director, and senior leadership levels to assess the effect of key program and policy decisions.
Provide strategic recommendations to leadership based on data and analysis.
Identify opportunities for cross-departmental or cross-regional projects, lead gathering of requirements and design of solutions.
Present data in an effective and understandable way, assist others in understanding how data can be used to lead improvement, and coach analysts on effective data translation.
Provide technical guidance or expertise to less experienced analysts particularly in Tableau, SQL, statistical or evaluative approach.
Provides review and feedback on analytic deliverables to promote consistency, quality, and adherence to team standards.
Projects and Collaboration
Lead projects with ISBI team to create or modify data sets.
Lead projects with internal and external stakeholders.
Coordinates distribution and prioritization of work across analysts in partnership with supervisor or manager.
Represent Analytics & Evaluation teams on cross-departmental workgroups and steering committees including leading follow up.
Make effective recommendations about how data-related projects should progress in order to meet intended goals.
QI Technical Assistance and Regulatory Compliance
Serve as subject matter expert on technical specifications of clinical measures and key data sets.
Coordinate QI technical assistance on development and distribution of data.
Supports onboarding and development of new analysts through training, mentoring, and knowledge transfer.
Present at internal/external workgroups and committees.
Identify training needs around quality improvement and data and implement solutions.
Develop, assess and implement new QI and reporting systems.
Identify need for process documentation for QI activities, create or lead process documentation projects within the QI team.
Coordinate regulatory deliverables across regions or teams and ensure timely submission; provide data/reports as needed.
SME for key regulatory deliverables and facilitates process for setting priorities and executing on process.
Serve as QI contact to OHA or CMS for regulatory meetings/deliverables.
Employee Leadership
Provides leadership for a team in support of team direction and goals.
Provides input into staffing needs; assists in recruiting, hiring, and leading a team to meet work needs, using an equity, diversity, and inclusion lens.
Participates in organizing, scheduling, monitoring and improving work; helps ensure employees have information to meet job expectations and have coverage during absences.
Contributes to the development, communication, and oversight of team and individual goals.
Trains, leads, and coaches employees; may facilitate team meetings.
Incorporates guidance from CareOregon equity tools into people leadership.
Helps monitor employee adherence to department and organizational standards, policies, and procedures.
Assists in evaluating employee performance; provides feedback to employees to support their success and feedback to supervisor in recognizing strong performance and addressing performance gaps and accountability (corrective action) as needed.
Performs lead tasks in collaboration with Human Resources as needed.
Organizational Responsibilities
Perform work in alignment with the organization’s mission, vision and values.
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals.
Adhere to the organization’s policies, procedures and other relevant compliance needs.
Perform other duties as needed.
Experience and/or Education
Required
Minimum 6 years’ experience in quality improvement, population health or a related field, including minimum 4 years data analytics experience (including Tableau and SQL)
OR
Bachelor’s degree in social science, science, or math with minimum 5 years’ experience in quality improvement, population health or a related field, including minimum 3 years data analytics experience
OR
Master’s degree in data analytics (e.g., health informatics, biostatics, business, data analytics, etc.), public health, or health administration with minimum 3 years’ experience in quality improvement, population health, or related field, including minimum 2 years data analytics experience
Preferred
Experience with people and/or project leadership
SQL for Snowflake experience
Knowledge, Skills and Abilities Required
Knowledge
Advanced knowledge of program evaluation methodologies and analytic strategies in a payer managed care setting or advanced skills in data visualization
Advanced knowledge of healthcare quality metrics (e.g. CCO incentive measures, Medicare Stars measures, HEDIS or other measure sets)
Advanced knowledge of population health, quality of care concepts and methodologies, and FQHCs, as well as concepts of community health and social determinants of health
Working knowledge of health equity, inclusion and diversity frameworks and how to apply them to data analytics
Skills and Abilities
Strong understanding of Tableau for analysis OR advanced proficiency in Tableau for data visualization and dashboard training
Strong understanding of SQL
Advanced proficiency with computer software programs, e.g. MS Outlook, Word, and PowerPoint
Advanced proficiency with MS Excel for data analysis and skills with large administrative database reporting functions and/or relational databases
Strong understanding of technical tools used for data analysis, visualization, and dashboard building with ability to support the team of Analysts in these roles and appropriately resource and prioritize department projects
Strategic thinker with ability to gather and analyze data, assess effectiveness of healthcare systems and work with system partners to develop, implement and evaluate Triple Aim improvement strategies
Understanding and ability to facilitate integration of clinical QI models and methods into existing programs
Strong interpersonal skills
Excellent communications skills to include: verbal, written, presentations, meeting facilitation and reports, specifically including the ability to present statistical and technical data in a clear and understandable manner utilizing appropriate visual aids and effectively facilitate and coordinate the work of a workgroup (including internal and external members) engaged in quality improvement activities
Ability to interface with and assist external stakeholders (providers, OHA staff, etc.)
Accountable, self-starter, able to work in a fast-paced environment
Possess a high degree of initiative and motivation along with the ability to effectively collaborate and plan with coworkers and others
Can independently manage timelines and deliverables with minimal supervision
Leadership capability and basic understanding of managerial concepts and techniques in areas such as work planning, training, delegating, coaching, mentoring, and evaluating.
Ability to lead initiatives and project teams
Ability to identify solutions, collaborate with management team, generate consensus, and motivate staff toward results
Ability to work effectively with diverse individuals and groups
Ability to learn, focus, understand, and evaluate information and determine appropriate actions
Ability to accept direction and feedback, as well as tolerate and manage stress
Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day
Ability to hear and speak clearly for at least 3-6 hours/day
Working Conditions
Work Environment(s): ☒ Indoor/Office ☐ Community ☐ Facilities/Security ☐ Outdoor Exposure
Member/Patient Facing: ☒ No ☐ Telephonic ☐ In Person
Hazards: May include, but not limited to, physical and ergonomic hazards.
Equipment: General office equipment and/or mobile technology
Travel: May include occasional required or optional travel outside of the workplace; the employee’s personal vehicle, local transit or other means of transportation may be used.
Work Location: Work from home
We offer a strong Total Rewards Program. This includes competitive pay, bonus opportunity, and a comprehensive benefits package. Eligibility for bonuses and benefits is dependent on factors such as the position type and the number of scheduled weekly hours. Benefits-eligible employees qualify for benefits beginning on the first of the month on or after their start date. CareOregon offers medical, dental, vision, life, AD&D, and disability insurance, as well as health savings account, flexible spending account(s), lifestyle spending account, employee assistance program, wellness program, discounts, and multiple supplemental benefits (e.g., voluntary life, critical illness, accident, hospital indemnity, identity theft protection, pre-tax parking, pet insurance, 529 College Savings, etc.). We also offer a strong retirement plan with employer contributions. Benefits-eligible employees accrue PTO and Paid State Sick Time based on hours worked/scheduled hours and the primary work state. Employees may also receive paid holidays, volunteer time, jury duty, bereavement leave, and more, depending on eligibility. Non-benefits eligible employees can enjoy 401(k) contributions, Paid State Sick Time, wellness and employee assistance program benefits, and other perks. Please contact your recruiter for more information.
We are an equal opportunity employer
CareOregon is an equal opportunity employer. The organization selects the best individual for the job based upon job related qualifications, regardless of race, color, religion, sexual orientation, national origin, gender, gender identity, gender expression, genetic information, age, veteran status, ancestry, marital status or disability. The organization will make a reasonable accommodation to known physical or mental limitations of a qualified applicant or employee with a disability unless the accommodation will impose an undue hardship on the operation of our organization.
CareOregon is a nonprofit, mission-driven health plan, focused on providing care to low-income Oregonians. The CareOregon family includes Columbia Pacific CCO, Jackson Care Connect, Housecall Providers and our work as part of Health Share of Oregon. We also support recruitment for the Oregon Health and Education Collaborative.
We're seeking talented individuals who want to make a difference.
Offices: 315 SW 5th Ave, Portland, OR 97204, US
MedicareMedicaidhealth carehealthcareand insuranceHealth Care
CareOregon is a nonprofit, mission-driven health plan, focused on providing care to low-income Oregonians. The CareOregon family includes Columbia Pacific CCO, Jackson Care Connect, Housecall Providers and our work as part of Health Share of Oregon. We also support recruitment for the Oregon Health and Education Collaborative.
We're seeking talented individuals who want to make a difference.
Offices: 315 SW 5th Ave, Portland, OR 97204, US
MedicareMedicaidhealth carehealthcareand insuranceHealth Care