Basic Function:Under limited supervision, the Quality Measures Developer provides advanced analytic and technical expertise in the development, programming, implementation, validation, and maintenance of electronic quality measures within healthcare settings. Responsibilities include developing, maintaining, and validating healthcare quality measures by interpreting specifications, mapping clinical data, performing testing and quality reporting analysis, and programming measure logic using SQL, CQL, Python, and other applicable programming languages and healthcare data standards. Write, debug, and enhance code and automated processes to capture, process, validate, and analyze electronic healthcare quality data, ensuring accuracy, compliance, and reporting readiness.
standards.
Organizational Relationships:Reports to the Director of Analytic ResourcesRole and Responsibilities:- Interpret quality measure specifications and translate clinical, regulatory, and business requirements into technical designs, executable measure logic, and reporting solutions.
- Design, develop, maintain, and optimize electronic quality measures using SQL, Clinical Quality Language (CQL), and related healthcare data standards.
- Perform data mapping, interoperability implementation, and integration activities utilizing standards such as FHIR, QDM, and related frameworks.
- Develop and execute validation strategies, test cases, and data quality assessments to ensure measure accuracy, reliability, and compliance.
- Analyze healthcare data, investigate discrepancies, and perform root cause analyses.
- Collaborate with clinicians, analysts, developers, and stakeholders to implement, maintain, and enhance electronic quality measurement solutions.
- Develop technical documentation, reports, and presentations to communicate measure performance, findings, and recommendations.
- Support modernization efforts through automation, advanced analytics, interoperability, and cloud-based solutions, improving the scalability, performance, and efficiency of quality measurement and reporting processes.
- Maintain measure specifications and support ongoing updates, regulatory reporting requirements, and system enhancements.
- Perform other duties as assigned.
Supervisory Responsibilities:N/A
Skills / Professional Competencies Required:- Strong knowledge of healthcare quality measurement, eCQMs, and quality reporting programs (CMS, HEDIS, Joint Commission, MIPS), with the ability to translate measure specifications and regulatory requirements into technical solutions.
- Proficiency in SQL, CQL, and related analytical tools for developing, maintaining, validating, and optimizing electronic quality measures and reporting solutions.
- Proficiency in programming languages and software development tools.
- Knowledge of healthcare data standards and interoperability frameworks, including FHIR, QDM, and HL7, as well as healthcare coding and terminology systems (ICD-10, CPT, HCPCS, SNOMED CT, LOINC, and RxNorm).
- Experience with healthcare data analysis, validation, testing, quality assurance, data integration, relational databases, data modeling, and ETL/ELT processes.
- Integrate quality measurement solutions with production, testing, compliance, and enterprise data systems to automate data collection, validation, and reporting, leveraging cloud-based data and analytics platforms, preferably Microsoft Azure and related technologies.
- Strong analytical, problem-solving, root cause analysis, organizational, and project management skills.
- Excellent written and verbal communication skills, with the ability to effectively present technical concepts and findings to both clinical and technical audiences.
Minimum Education/Training Required:Bachelor's degree from an accredited four-year college or university in Health Informatics, Computer Science, Mathematics, Data Analytics, or a related quantitative or technical discipline.Minimum Experience Required:At least five (5) years of experience in healthcare quality measurement, health informatics, healthcare analytics, clinical reporting, healthcare technology, software development, or a related field.Substitution(s):A Master's degree in a relevant discipline may substitute for up to two (2) years of applicable experience. Relevant certifications in healthcare informatics, quality measurement, interoperability, analytics, software development, cloud technologies, or healthcare coding may substitute for up to one (1) year of related experience.
Licensure/Certification Requirements:N/A
Security Level:Low
Working Conditions and Physical Requirements:The
physical demands marked below are representative of those that will be required to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
RequirementYes/NoLifting (lbs.)
If yes, Specify Range:
Up to 25 pounds
Yes
Carrying (lbs.)
If yes, Specify Range:
Up to 25 pounds
Yes
Stooping, Bending
Yes
Kneeling, Squatting
Yes
Walking
Yes
Standing
Yes
Sitting
Yes
Climbing, Balancing (e.g., climbing and working from ladder)
No
Use of Hands to Finger, Handle, or Feel
Yes
Physical Coordination (sequential or simultaneous use of hands, arms, feet, and legs)
Yes
Eye-Hand Coordination
No
Close Vision (clear vision at 20" or less)
Yes
Distance Vision (clear vision at 20' or more)
No
Color Vision (ability to identify and distinguish colors)
No
Depth Perception (ability to judge distance spatial relationships)
No
Hearing in person
Yes
Hearing on telephone
Yes
Speaking in person
Yes
Speaking on telephone
Yes
The environmental conditions marked below are common to this job:
ConditionYes/NoOutdoor Weather Conditions
No
Wet, Humid Conditions (non-weather)
No
Work Near Moving Mechanical Parts
No
Work in High, Precarious Places
No
Fumes or Dust
No
Toxic or Caustic Chemicals
No
Extreme Heat (non-weather over 90 deg. F.)
No
Low Noise (e.g. business office)
Yes
Moderate Noise (e.g., light motorized equipment such as lawn mowers)
No
Loud Noise (e.g., jackhammer, heavy motorized equipment)
No
