Quality Performance Operational Analyst

$62,816 - $83,304/Yr

Kern Health Systems - Bakersfield, CA

Part-time - Entry Level

Bakersfield, CA

501-1,000 employees

About the position

The Quality Performance Operational Analyst position at Kern Health Systems is a vital role that provides operational support for various processes, projects, and assignments within the organization. This position is focused on Quality Performance (QP) reporting needs, specifically related to the Managed Care Accountability Set (MCAS), HEDIS, and site review reporting. The Operational Analyst will act as a subject matter expert, ensuring that the department's reporting needs are met effectively. This includes utilizing light data queries and self-service reporting tools to support dynamic assignments based on operational needs, as well as participating in annual corporate projects and long-term functional assignments. The role requires the Operational Analyst to gain expertise in departmental systems through hands-on experience and training. This position is central to addressing the needs of the assigned operational business unit, leveraging data analytics to facilitate operational discussions both internally and externally. The analyst will report findings to management for review and provide recommendations for process improvements, assisting in the development of action plans to implement necessary corrections. Additionally, the Operational Analyst will oversee and validate data submissions for the annual Department of Health Care Services (DHCS) MCAS/HEDIS audit, serving as a liaison between the QP Department, vendors, and other internal departments such as IT. This role is crucial for ensuring compliance and accuracy in reporting, which directly impacts the quality of care provided to members.

Responsibilities

• Provide operational department support for processes, projects, or assignments related to an assigned operational discipline.
• Serve as the subject matter expert for Quality Performance reporting needs related to MCAS, HEDIS, and site review reporting.
• Utilize light data queries and self-service reporting tools to support operational needs.
• Participate in Agile and Project Management methodologies from planning to execution.
• Learn and understand business software systems and manual processes to identify efficiencies.
• Deliver high levels of customer service to internal and external customers.
• Perform routine operational processes in support of the department's mission.
• Manage and validate data and report submissions for the DHCS MCAS/HEDIS audit.
• Collaborate with MCAS software vendors to implement requirements as outlined by HSAG and DHCS.
• Facilitate MCAS presentations to diverse audiences and manage project tasks efficiently.

Requirements

• Bachelor's degree in Business, Business Management, Mathematics, or a related field with analytical skills; OR six years of experience with a Managed Care Organization in a business role with two years in a business analytical capacity.
• Experience with Managed Care Organizations or similar types of organizations.
• Advanced skills in Microsoft Office Suite, particularly in creating presentations, templates, charts, and pivot tables.
• Ability to create simple SQL statements for department-specific analytics.
• Strong verbal and written communication skills, with the ability to interact professionally with diverse groups.

Nice-to-haves

• Experience with Agile and Project Management methodologies.
• Knowledge of medical terminology and operations in a payor environment.
• Ability to work independently and maintain confidentiality.

Benefits

• Medical care (including prescriptions), vision, and mental health coverage.
• Dental care.
• Long-term disability and life insurance coverage.
• Employee assistance program.
• Healthcare for dependents.
• Wellness programs.
• Retirement plans including 457(b) and 401(a) plans.
• Paid time off and extended illness bank.
• Employee discount programs.
• Training and professional development courses.