Clinical Quality Analyst Job Description
Clinical quality analyst
provides training on HEDIS/Star Measures, preventive health topics with a focus on medications, their use, side effects and access to medications.
Clinical Quality Analyst Duties & Responsibilities
To write an effective clinical quality analyst job description, begin by listing detailed duties, responsibilities and expectations. We have included clinical quality analyst job description templates that you can modify and use.
Sample responsibilities for this position include:
Completes all needed reporting to meet corporate end user needs on a timely and effective basis including HEDIS and P4P (Pay for Performance Bonus/internal scorecards
Identifies client issues
Maintain user profiles in the clinical applications as needed
Assist in the preparation of written reports regarding progress of clinical IT project implementations including but not limited to progress, barriers
Work cross functionally and coordinate with others internally or externally to gather information
Mine data and/or information to identify inconsistencies, trends, other information needed, (e.g., develop and/or run data queries)
Mine claims and case management software for data to assist in the development of preventive care programming determine outcomes of implemented programs
Works with some guidance
Some proficiency in understanding of basic process management and total quality management principles and methodologies (e.g., Six Sigma
Support the analysis of quality auditing findings as it relates to business process information (e.g., metrics
Clinical Quality Analyst Qualifications
Qualifications for a job description may include education, certification, and experience.
Licensing or Certifications for Clinical Quality Analyst
List any licenses or certifications required by the position: CPHQ, CPC, CCM, PMP, NCQA, PCMH, OASIS, CRC, BLS
Education for Clinical Quality Analyst
Typically a job would require a certain level of education.
Employers hiring for the clinical quality analyst job most commonly would prefer for their future employee to have a relevant degree such as Bachelor's and Master's Degree in Healthcare, Nursing, Public Health, Business, Health, Healthcare Administration, Education, Information Technology, Business/Administration, Science
Skills for Clinical Quality Analyst
Desired skills for clinical quality analyst include:
Microsoft SharePoint
Medical terminology
HEDIS Standards
Joint Commission survey processes
Medications and treatments prescribed in a primary care office
ASAM Dimensions and use for assessment and treatment planning
HEDIS
Human anatomy and physiology
ICD-9 codes
Desired experience for clinical quality analyst includes:
Minimum of two (2) years of experience in Long Term Care
Require knowledge of MDS 3.0 documentation requirements
Require knowledge of accreditation standards and compliance requirements
Support engagement with relevant stakeholders (e.g., end users
Proven record of positive, effective coaching and development ability supporting effective team interactions
1+ year in a Clinical Contact Center environment required
Clinical Quality Analyst Examples
1
Clinical Quality Analyst Job Description
Job Description Example
Our company is looking for a clinical quality analyst. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for clinical quality analyst
- Work closely with local teams corporate teams
- Serve as a resource to other team members
- Identify possible correlations between process metric/results and outcomes
- Support of data entry system design, to ensure smoother, more consistent, more reliable back end reports and analysis
- Manage, create, and ensure timely distribution of reports on scheduled cadence
- Provide data knowledge support to design of new quality metrics, and revision of current metrics
- Development of close working relationship with Analytics team, to act as liaison between Health Services and Analytics, and to address data-related questions
- Present findings, issues, and action plans as requested to senior leadership
- Work with CQM team members to map data into a common repository
- Create comprehensive reporting from Hospital Compare data
Qualifications for clinical quality analyst
- One (1) year of reporting and data analysis experience within managed care organizations with claims data, provider data, and/or utilization data strongly preferred
- Working knowledge of administrative claims data and medical coding systems
- Graduate from accredited nursing school
- Graduate degree preferred in nursing, business or healthcare field
- 3-5 years direct patient care experience preferred in cardiology or cardiology related area
- Basic computer skills to include EMR and Excel skills
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Clinical Quality Analyst Job Description
Job Description Example
Our company is growing rapidly and is hiring for a clinical quality analyst. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for clinical quality analyst
- Collaborate with CQM and other key departments to obtain Health plan measures, develop interventions
- You can be a part of this team
- Assists with and may conduct clinical Training quality audits of materials
- Conducts internal audits, analysis, and reporting of clinical documentation compliance with guidelines, SLA’s, and regulations
- Collects and summarizes performance data, performs adequate data/barrier analysis, identifies opportunities for improvement, develops improvement recommendations, presents findings/recommendations to the Quality Assurance Committee and other committees as appropriate, and deploys actions as approved
- Participates as needed in various UM or Quality committees and work groups convened to improve process and/or health outcomes, and contributes meaningful details, based on functional knowledge
- Serves as knowledge expert for continuous quality improvement activities
- Participates on performance improvement teams in the development of activities to address identified barriers in arriving at desired outcome
- Ensures that documentation produced and/or processes conducted comply with state regulations and/or accrediting body requirements
- Develop, write, organize and maintain the information and reports needed to understand and improve practice patterns and patient outcomes at Swedish
Qualifications for clinical quality analyst
- 3+ years of experience working with clinical data and clinical data exchange solutions including HL7 and related interoperability standards such as v2.x messages/message files, CCD, HITSPC32/CCD, C-CDA,CDA unstructured documents, CALINX, IHE profiles
- Intermediate computer skills (Microsoft Word, Excel and Outlook ) with the ability to navigate a Windows environment
- Experience working with Providers or Vendors
- Presentation and Microsoft PowerPoint skills strongly preferred
- CCM certification Highly Preferred
- Excel skills (Pivot Tables, Macro’s)
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Clinical Quality Analyst Job Description
Job Description Example
Our innovative and growing company is looking to fill the role of clinical quality analyst. Thank you in advance for taking a look at the list of responsibilities and qualifications. We look forward to reviewing your resume.
Responsibilities for clinical quality analyst
- Ensures the accuracy and comprehensiveness of the reports and data sources, and provides support and training on reporting and related topics
- Assists with and executes project planning (including planning, organizing, and managing resources) and all phases of the project management life cycle for a variety of initiatives related to physician practice initiatives that bring about beneficial changes or added value
- Actively responds to questions and queries, work to reinforce best practices and methods, and provides follow up support
- Works with internal and external sources to support enhanced automation of data acquisition and reporting through EPIC and other clinical data systems
- Manages multiple tasks and projects simultaneously
- Conduct, monitor and report on analyses to identify practices that enhance the value of care provided by drilling into the components of care such as patient flow, medical supplies and devices, pharmaceuticals, laboratory testing, nursing care, radiology testing, surgical services, therapy services
- Assess the application of evidence-based clinical standards and clinical reengineering processes and their impact on operations, quality, cost, and resource utilization
- Monitor physician practice performance based on productivity, quality, resource utilization, and cost efficiency
- Perform patient type profile analysis to assess profitability, case mix, care coordination/management
- Analyze opportunities associated with the standardization of supplies, devices, pharmaceuticals, and other products used in delivering care
Qualifications for clinical quality analyst
- Knowledge of accreditation, federal and state regulations/requirements
- Ability to research various venues to obtain pertinent data
- Three years of recent SQL programming experience required
- Bachelor's degree in Health Care Management, Business Administration or Finance/Economics
- Clinical degree and/or experience working in a healthcare environment is highly desirable
- Advanced MS Excel application experience and Power Point
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Clinical Quality Analyst Job Description
Job Description Example
Our growing company is hiring for a clinical quality analyst. To join our growing team, please review the list of responsibilities and qualifications.
Responsibilities for clinical quality analyst
- Collaborate with Quality & Value, Accountable Care Services, Decision Support, and Financial Analyst teams, physicians, clinic administrators, health plan partners, other Swedish teams and ACO and Providence partners to design routine and ad hoc reports on patients’ care and outcomes to drive improvement
- Establish SQL database structure and facilitate routine and non-routine importation of data into the database and be able to query Epic’s Clarity database and other data from Epic other Swedish/Providence data sources
- Code review and other collaboration with Swedish and Providence program developer/database administrators to ensure coordination of efforts and best-practice sharing where useful
- Perform quality assurance/quality control reviews of clinical trial registration submissions for consistency with review criteria
- Clearly communicate (via email and record reviews) with “responsible parties” (i.e., clinical trial sponsors, designated principal investigators) regarding consistency of clinical trial record with review criteria
- Perform general proofreading
- Create new documentation to help responsible parties submit their clinical trial records in accordance with established review criteria
- Post records in accordance with established deadlines
- Monitor data for trends or patterns of problems (e.g., consistent series of errors from a single data provider) and participate in process improvement
- Support database management activities
Qualifications for clinical quality analyst
- A Bachelor's Degree in Nursing, Physical Therapy or other related Health Care Field
- Demonstrated experience in complex organizations serving diverse constituencies with focus on analytics, project management, health care management, business administration and related fields
- Attention to detail, patience, and a positive, customer-centric attitude which includes empathy, tact, and emotional maturity
- Good communication and interpersonal skills that support productive work with all levels of staff, and effective communications with diverse populations
- Current state RN or LPN license or an Associate’s degree in a Healthcare-related field
- CPC, CRC, RHIA, or CCS Certification
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Clinical Quality Analyst Job Description
Job Description Example
Our company is growing rapidly and is looking to fill the role of clinical quality analyst. We appreciate you taking the time to review the list of qualifications and to apply for the position. If you don’t fill all of the qualifications, you may still be considered depending on your level of experience.
Responsibilities for clinical quality analyst
- Conducts file audits for clinical quality issues
- Provides feedback to practitioners and/or internal clinical staff on performance
- Writes standard operating procedures and project-related documents
- Tracks internal and external corrective and preventive actions
- Maintains audit-related documents
- Recognizes the need for and organizes training programs
- Provides mentoring to junior QA staff
- Keeps current on regulations and guidance
- Reviews and writes standard operating procedures and other QA policies
- Writes audit plans and reports
Qualifications for clinical quality analyst
- Systems literate and hands-on
- Current state RN license or a Bachelor’s degree in a Healthcare-related field
- 1-3 years of demonstrated computer literacy and knowledge of information systems and comparative data bases
- Associate’s degree in a Healthcare-related field or current state RN or LPN license
- Certification by the Healthcare Quality Certification Board (HCQB) as a Certified Professional in Healthcare Quality (CPHQ)
- Minimum of 5 years of experience in Quality Database and/or system management preferred