Bachelor's degree in an analytical field; Master's preferred.
5-8 years of experience in an analytic field; managed care experience preferred.
Understanding of CAHPS and HOS measures, methodologies, and regulatory requirements.
Proven ability to manage complex regulatory projects and ensure compliance with CMS and state requirements.
Strong proficiency in Microsoft Office applications and experience with statistical software (MS Access, SAS, or R).
Responsibilities
Support the CAHPS Director in developing and evaluating quality improvement strategies.
Ensure focus on measures critical for quality incentive programs from regulatory bodies.
Prepare and present performance and outcome reports to leadership and stakeholders.
Lead and coordinate meetings with key stakeholders to achieve quality goals.
Manage operational activities related to HOS and CAHPS survey vendors.
Analyze survey results and member feedback to identify improvement opportunities.
Coordinate annual regulatory survey activities to ensure compliance.
Benefits
Hybrid work model offering flexibility.
Opportunity to lead impactful quality improvement initiatives.
Collaboration with diverse teams and external partners.
Engagement in special projects that enhance professional growth.
Full Job Description
Position Overview
The primary function of the Health Outcomes Survey (HOS) Lead is to provide leadership in developing, implementing, monitoring and coordinating quality improvement initiatives that support the goal of improving HOS and Consumer Assessment of Healthcare Providers and Systems (CAHPS) measures across all lines of business. This position will work directly and collaboratively across all MetroPlus departments, external partners and with Provider Groups/Facilities to achieve Plan goals for improving HOS and CAHPS measures. This position will serve as the subject matter expert for HOS and support CAHPS quality improvement and regulatory survey activities under the direction of the CAHPS Director.
Scope of Role & Responsibilities
Support the CAHPS Director in the development, implementation and evaluation of quality improvement strategies, including root cause analyses, action plans, performance monitoring and corrective interventions to improve HOS, CAHPS and related member experience measures.
Ensure focus on measures that are important for achieving/maximizing quality incentive programs established by regulatory bodies including but not limited to CMS, NYS DOH, etc.
Prepare and present HOS and CAHPS performance, intervention, and outcome reports to leadership, committees, workgroups, and external stakeholders, as appropriate.
Lead and coordinate HOS and CAHPS specific meetings with key stakeholders (internal and external business partners) with regular frequency to achieve quality goals.
Manage day-to-day operational activities associated with the HOS and CAHPS survey vendors, including survey administration, project oversight, monitoring of deliverables and support of all required regulatory reporting and submissions.
Monitor and analyze CAHPS and HOS survey results, key driver analyses and related member feedback to identify opportunities for improving member experience and survey performance.
Coordinate and support annual regulatory HOS and CAHPS survey activities, ensuring compliance with CMS, NYS DOH and other applicable regulatory requirements.
Collaborate with internal departments, provider partners and vendors to implement interventions aimed at improving member-reported health outcomes and member experience measures.
Participate in special projects as needed.
Required Education, Training & Professional Experience
Bachelor's degree in analytical field including Finance, Health Care Management or related field. Master's Degree a plus.
Five to eight years' experience in any analytic field. Two to three years of managed care experience preferred.
Understanding of CAHPS and HOS measures and methodologies with knowledge of HEDIS, QARR, Medicare Star Ratings. Quality Incentive Programs and regulatory reporting requirements strongly preferred.
Demonstrated ability to manage complex regulatory projects and maintain compliance with CMS and state survey administration requirements.
Knowledge of quality improvement activities such as PDSA preferred.
Must have strong working knowledge of Microsoft Office applications including Word, Excel, Access and PowerPoint.
Experience with relational database/statistical applications (MS Access, SAS or R) strongly preferred.
Professional Compentecies
Must be proficient in Microsoft Word, PowerPoint, Excel, and Access.
Demonstrated interpersonal/verbal communication skills.
Experience with and proficient in data analysis. Working knowledge of relational database and statistical analyses is a plus.
Must be familiar with and have a working knowledge with QI process improvement methodology strategies including but not limited to PDSA and DMAIC.
Must possess analytical skills to collect, organize and present data in a clear and concise manner.
Ability to assess all work and prioritize as necessary to meet reporting timeframes and deadlines.
Demonstrated problem solving skills.
Ability to work in a fast-paced environment with changing priorities.
