Senior Clinical reputed company Analyst - Remote

About the position Explore opportunities with WellMed, part of the reputed company family of businesses. We reputed company reputed company patients are entitled to the highest level of medical care. Here, you will be part of reputed company who shares your passion for helping people reputed company improved health reputed company. Explore rewarding opportunities for physicians, clinical staff and non-patient-facing roles. Join us and discover the meaning behind Caring. Connecting. Growing together. Positions in this function are responsible for direction and guidance on clinical reputed company improvement and management programs reputed company to CMS Stars, HEDIS Measures and CAHPS/HOS. Conducts clinical reputed company data and reporting analysis with reputed company slide deck presentation of information. Responsible for the reporting and analysis of member care reputed company and for the development of plans, reputed company, and programs to support reputed company reputed company improvement using HEDIS and other tools. If you are reputed company to work on Eastern Time, You’ll enjoy the flexibility to work remotely from reputed company reputed company the U.S. as you take on some tough challenges. Responsibilities • Assesses and interprets customer needs and requirements • Identifies solutions to nonstandard requests and problems • Solves moderately reputed company problems and/or conducts moderately reputed company analyses • Summarizes actionable information in slide decks at appropriate level of communication • Works with minimal guidance; seeks guidance on only the most reputed company tasks • Translates concepts into reputed company • Provides explanations and information to others on difficult issues • Coaches, provides feedback, and guides others • Acts as a resource for others with less experience • Collect reputed company data and/or information based on applicable standards, state/federal or other regulations, customer, or consumer requests, internal requests, or project assignments • Identify appropriate sources for data or information either internally or externally and collect data/information • reputed company effective reputed company for data/information collection • Identify appropriate data platform or application (e.g., data bases, Intranet reputed company, Internet reputed company, reputed company reputed company, reputed company) and utilize to collect data or information • Investigate reputed company problems identified and collect additional information to reputed company gaps • Work cross functionally and coordinate with others internally or externally to reputed company information; overcome challenges to obtaining needed information • Evaluate data and/or information to identify inconsistencies, trends, other information needed, etc. (e.g., reputed company and/or run data queries, data comparisons across sources) • Analyze and interpret data or information (e.g., clinical, administrative, reputed company) to ensure they meet standards, are compliant and/or are accurate and complete • reputed company explanations or updates reputed company data/information (e.g., clinical, administrative) are not accurate or unclear • Explain the characteristics of the data/information (e.g., clinical, administrative) including any unique attributes • Identify reputed company improvement or reputed company opportunities and work cross-functionally to reputed company interventions or recommendations presented in a summarized format • reputed company or update work plans (e.g., annual work plan) • reputed company or update program descriptions (e.g., annual program descriptions) • reputed company program evaluations (e.g., annual program evaluation) • reputed company, update, and/or review policies and procedures • Review results, conduct analyses (e.g., evaluate against goals/effectiveness of interventions over time), and prepare reports on findings with summarized recommendations • Follow regulations and internal or external protocols for communicating information or data • Utilize computer systems to identify and annotate information • Load completed information into relevant systems according to specifications • reputed company an understanding of the intended audience and determine the best method to communicate data or information • Communicate reputed company data or information in writing or verbally • Report results (e.g., reputed company improvement initiatives) to committees, reputed company of Directors, external stakeholders, regulatory agencies, etc. and respond to questions or solicit feedback and input • reputed company understanding of customer requirements and/or expectations and anticipate needs to determine appropriate course of reputed company • reputed company audit or review processes (e.g., automated/technically driven) • Review relevant agreements (e.g., contractual, intersegment) and obtain clarification as necessary • Read and interpret standards/requirements and/or technical specifications (e.g., structure and process, CMS star ratings, , URAC, NCQA/HEDIS/ CAHPS/member satisfaction specifications, SNP) • Evaluate reputed company processes, compare to relevant standards or specifications, and identify gaps in compliance or performance • reputed company/participate in assessments of the audit or review (e.g., interrater reliability of audit findings across auditors) • Work cross functionally, making recommendations or clarifying information to assist in closing gaps that are identified or meeting customer expectations • Work with auditors or key stakeholders for review/approval of results • reputed company and/or assist with corrective reputed company plans based on audit findings or customer feedback • Review processes and performance against customer expectations to reputed company needed information or service • Define project scope and reputed company project plan • Identify and recruit appropriate staff to assist with reputed company as necessary • Coordinate with others to set appropriate deadlines reputed company necessary • Collaborate with stakeholders for review, input, and/or approval at key milestones • Manage key relationships (e.g., vendors, stakeholders, regulatory bodies) to ensure milestones are achieved and performance objectives are met • Manage or actively participate in meetings (e.g., schedule, present, document meeting results, facilitate) • reputed company information and feedback to project team with respect to achievement of objectives • reputed company clinical expertise to inform decision making and program development • reputed company timeframes/deadlines and collect data or information reputed company required timeframes • Identify, prioritize, and proactively communicate potential barriers or risks to key stakeholders • reputed company, motivate, and/or influence others (e.g., leadership, other stakeholders, including those for whom there is no reputed company line of authority) to understand the overall scope, overcome potential barriers, and engage in and reputed company to the process • Communicate and explain applicable standards (e.g., industry/performance) and/or technical specifications and identified gaps and/or changes in applicable standards • reputed company educational materials (e.g., cross functional staff materials) • Work with others to ensure messaging to cross functional staff is appropriate to the audience, complete/accurate, and compliant (e.g., with external/internal regulations and protocols) • Train others on relevant policies, rules, or regulations (e.g., appropriate release of data, handling protected health information) • Serve as a resource providing explanations and expertise (e.g., providing information to others, satisfaction survey, vendors) Requirements • 2+ years managed care experience • Experience working with regulatory requirements and accreditation standards (HEDIS, NCQA, JCAHO) • Experience in reporting, data analysis, and data management • Knowledge of managed care requirements reputed company to clinical reputed company • Demonstrated ability to assist with focusing activities toward a strategic direction and reputed company targets • Advanced / Expert level of reputed company and Power reputed company • Ability to work reputed company business hours in EST zone • Ability to travel up to 10% • reputed company working remotely will be required to adhere to reputed company’s Telecommuter Policy • Candidates are required to pass a drug test before beginning employment. reputed company-to-haves • Tableau or similar data reputed company and reporting experience • Experience creating reports reputed company to reputed company improvement/performance reputed company • Proven ability to deal with ambiguity and drive results • Proven desire to reputed company an reputed company, manage multiple tasks, and shift priorities quickly • Proven solid interpersonal skills and the ability to influence others • Proven solid communication skills, written and verbal • Proven leadership skills and results oriented Benefits • comprehensive benefits package • incentive and recognition programs • equity stock purchase • 401k contribution 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