Job Description:

Job Description

The Senior Associate, Quality Data works the Manager, Quality Data to own and maintain Cityblock's quality data infrastructure, supporting proper data ingestion and transformation ('Data In') as well as quality gap segmentation and evidence submission ('Data Out'). Key activities can include: overseeing and auditing incoming and outgoing Quality-related data pipelines between Cityblock and payer partners; managing and expanding Cityblock's use of external clinical data pipelines (ADT Notification, Lab Result, Medication Dispense, Medical Records, etc.) to drive quality measure performance improvement; maintaining a mastery of technical and clinical specifications across HEDIS / Medicare Stars quality measures and Cityblock's quality contracts; serving as a subject matter expert to Cityblock's Tech and Clinical organizations on Quality Data requirements and opportunities; providing actionable insights on quality gap performance and closure opportunities to frontline care teams and managers.

Responsibilities

• Oversee the intake, validation, and management of quality data from all payors, ensuring accuracy, completeness, and timeliness; use SQL to perform preliminary investigation of data issues and lapses directly in Cityblock data warehouses / data lakes, and partner with Quality Strategy, Partner Success, and/or Tech to remediate
• Partner with Client Reporting and Analytics to establish, audit, and submit supplemental clinical data files for all payors in compliance with HEDIS/NCQA, CMS, and payer contractual requirements, with clear data provenance for all submitted records
• Leverage Cityblock's broad clinical data to develop suspecting algorithms that predict opportunities for gap closure and/or exclusion via medical records research; support the Quality Research team in researching these opportunities
• Test quality data models, make targeted modifications as needed, and independently analyze large datasets to surface underlying trends in gap performance, without relying on other teams for routine analysis
• Collaborate with the Network & Partnerships team as well as external chart retrieval vendors, in order to secure access to primary-source medical records that support quality gap closure and/or exclusion
• Partner with the Manager, Quality Operations as well as frontline care team managers and clinical leadership to ensure provider and care team documentation meets HEDIS standards and supports effective gap closure; work with these partners to surface and remediate documentation gaps
• Collaborate with Quality Analytics and Quality Operations to ensure quality performance reporting, dashboards, and operational workflows are aligned with HEDIS/NCQA and CMS standards for gap closure
• Support quality tooling and technology implementations, ensuring proper validation, quality checks, and effective use across the organization while contributing to a high-performing, collaborative Quality team.

Requirements

• 3+ years of experience focused on healthcare domains such as quality improvement, population health, care management, and/or risk adjustment
• Proficiency in SQL for querying, validating, and analyzing datasets too large to work with in spreadsheet tools (e.g. Google Sheets), including testing and modifying data models
• Ability to interpret BI / visualization tools (e.g. Looker, Tableau, Power BI) and use them to analyze data and identify trends
• Experience with a scripting language (e.g. Python, R) for data wrangling, exploratory data analysis, and light automation, including developing suspecting logic

Nice-to-Have:

• Strong preference for experience with HEDIS / Medicare Stars quality programs
• Experience with value-based care reimbursement models, and/or experience with government-sponsored/regulated lines of business (Medicare, Medicaid, ACA Exchange)

We take into account an individual's qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company's equity program, paid time off, including vacation and sick leave. The actual offer will be at the company's sole discretion and determined by relevant business considerations, including the final candidate's qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:
$80,000 - $102,000