Manager, Clinical Quality Analytics

Salary Range:  $117,509.00 (Min.) - $152,762.00 (Mid.) - $188,015.00 (Max.)

 

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation’s largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care’s mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.
 

Job Summary

The Manager of Clinical Quality Analytics (MSA) is responsible for the operations, projects and planning of the reporting and analytics on quality programs for all of L.A. Care’s line of business (LOB) which includes Medicare Stars, Exchange Quality Rating Systems and MediCal’s Managed Care Accountability Sets, and other data-sharing and/or quality improvement programs focused on enhancing member experience and quality of life. The MCQA is responsible for analyzing, monitoring, reporting, and providing technical collaboration and data driven decision making on clinical and operational quality improvement activities related to these programs. The MCQA recommends policies, and leads process improvement efforts.

 

Additionally, the MCQA works with the Quality Improvement team, department leadership, and the provider network on developing plan-wide quality improvement and data strategy activities. The MCQA assists in developing a long-term plan for analytics and evaluation activities to support the quality improvement strategy and goals, including enterprise wide data and analytics solutions. The MCQA manages all aspects of running an efficient team, including hiring, supervising, coaching, training, disciplining, and motivating direct and indirect staff reports.

Duties

Leverage data to inform targeted strategies that indicate whom to engage, with what content and through which channel and frequency: prioritize members and providers based on characteristics, such as RAF scores, open care gaps and quality improvement performance to enable a targeted and tailored outreach for members and providers through preferred channels - web, print, email, etc.

 

Implement a data-driven quality improvement strategy and predictive model to prioritize a set of measures that will drive higher quality ratings.  Evaluate measures on a regular schedule to accommodate quality improvement performance changes throughout the year. These insights will enable accountable entities to make in-flight adjustments as needed, throughout the measurement year.

 

Establish streamlined and accurate process for quality improvement performance scorecards at the contract, provider and member level along with predictive analytics models. Work closely with QPM, HIM and other analytics teams and vendors to ensure provider web based quality tools used to monitor performance and close diagnosis and care gaps are complete, accurate, and timely and provide actionable insights at the member level.

Develop meaningful dashboards, reports, tools, and presentations to inform and influence Stars strategy and related activities.

Act as an analytics and technical subject matter expert on teams working on development and execution of Stars strategic initiatives.

Work closely with Quality Improvement team to manage and lead quality reporting and analytical strategies to enable accountable entities and stakeholders to drive quality ratings improvement for CAHPS, HOS, HEDIS, Medication Adherence and Plan Operations

 

Manage staff, including, but not limited to: monitoring of day to day activities of staff, monitoring of staff performance, mentoring, training, and cross-training of staff, handling of questions or issues, etc. raised by staff, encourage staff to provide recommendations for relevant process and systems enhancements, among others.

Perform other duties as assigned.

Duties Continued

Education Required

Bachelor's Degree in Business or Related FieldIn lieu of degree, equivalent education and/or experience may be considered.

Education Preferred

Master's Degree in Public Health or Health Informatics

Experience

Required:

At least 6 years of experience in HEDIS, quality improvement, risk adjustment analytics, research, or related work within a healthcare context.

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