Job Summary:

• Participates in requirements and use case/user story reviews.
• Provides accurate estimates for QA resources and testing schedules.
• Responsible for creating and gaining project approvals on project test plans.
• Responsible for creating and/or overseeing the creation and approval of project test cases.
• Responsible for assisting with automating and executing automated test cases.
• Responsible for generating all QA-related documentation.
• Ensures adherence to standardized QA policies, processes, and documentation standards.
• Executes test cases, defect management, and adherence to test schedule.
• Performs in-depth analysis by weighing relevance and accuracy of information to provide alternative solutions while appropriately incorporating input from others.

Skills on Resume:

• QA Strategy Development (Hard Skills)
• Test Plan Approval (Hard Skills)
• Test Case Oversight (Hard Skills)
• Automated Testing Management (Hard Skills)
• QA Documentation Control (Hard Skills)
• Process Standardization (Hard Skills)
• Defect Management (Hard Skills)
• Analytical Problem Solving (Soft Skills)

Job Summary:

• Assist to collect, validate, transform, and store data into SQL from multiple sources
• Assist in maintaining SQL databases used for data storage, procedures, and SQL jobs
• Create automation and time-saving solutions
• Create reports and presentation materials using Microsoft Excel, Microsoft Access, SQL Reporting Services, Tableau or other data manipulation software
• Assists health plan to maintain State and regulatory quality and care reporting standards while ensuring timely submission
• Assists with HEDIS and accreditation reporting requirements
• Use specialized health plan knowledge and analytical skills to perform complex research and analyses
• Generally works independently under the supervision of the Clinical Quality Manager
• Participates in or coordinates with other department projects 

Skills on Resume:

• Data Validation (Hard Skills)
• SQL Database Maintenance (Hard Skills)
• Automation Solutions (Hard Skills)
• Advanced Reporting (Hard Skills)
• Regulatory Compliance (Hard Skills)
• Health Reporting Standards (Hard Skills)
• Healthcare Data Analysis (Hard Skills)
• Project Coordination (Soft Skills)

Job Summary:

• Participates with medical staff leadership and physicians/clinicians to identify and faciltate implementation of best practices and recommend enhancements to processes or stands to support mitigation of risk and improvement of quality.
• Track progress and remediation of plan of correction and performance improvement activities related to quality
• Participating in quality related projects and/or training throughout the organization. 
• Identifies cases meeting criteria for physician review (mortality, morbidity, blood usage, infection, adverse drug reactions, unusual occurrences needing improvement) 
• Produces reports and presentations on quality and conducts drill down analysis to proactively identify specific variance in practice patterns. 
• Works collaboratively with report requestors, providing guidance to define repot requirents and validate results.
• Identifies opportunities for operational inefficiencies and collaborates with QA leadership, conducting primary and tertiary screening of patient care variances, through chart audits & applications.
• Works collaboratively across departments to understand and meet the organziation's clinical quality analytic needs. 
• Plays an active role in clincial evaluation of quality metrics, bold goals and patient outcomes. 
• Uses Lean principles in work processes.
• Be liaison to the external reporting groups such as Truven, CMS, CHART, Leapfrog, and others as assigned. 
• Initiating chart review audits to validate quality outcome data prior to release to external federal and state agencies. 
• Meets productivity and timeline targets and uses tools to track activities and timelines.

Skills on Resume:

• Best Practices Implementation (Hard Skills)
• Quality Tracking (Hard Skills)
• Quality Project Participation (Soft Skills)
• Clinical Data Analysis (Hard Skills)
• Report Generation (Hard Skills)
• Operational Collaboration (Soft Skills)
• Quality Metric Evaluation (Hard Skills)
• External Liaison (Soft Skills)

Job Summary:

• Analyze medical, cost, diagnosis data to identify possible outcomes
• Review utilization reports, national trends, and patient outcomes, and identify areas where improvement is needed/possible
• Assess risks associated with individual claimant treatments for diagnoses
• Provide consistent fact-based education to ensure a repeatable, defendable process
• Provide data and rationale to explain alternative options/level of care/processes and improve overall outcomes
• Uses pertinent data and facts to identify and solve a range of problems within area of expertise
• Investigates non-standard requests and problems, with some assistance from others
• Works exclusively within a specific knowledge area
• Prioritizes and organizes own work to meet deadlines
• Provides explanations and information to others on topics within area of expertise

Skills on Resume:

• Data Analysis (Hard Skills)
• Utilization Review (Hard Skills)
• Risk Assessment (Hard Skills)
• Process Education (Soft Skills)
• Outcome Improvement (Hard Skills)
• Problem Solving (Hard Skills)
• Task Prioritization (Soft Skills)
• Expert Communication (Soft Skills)

Job Summary:

• Develop analyses that help the organization understand and monitor quality performance, break down key drivers, and identify opportunities for improvement
• Create operational reports and high-impact dashboards using tools like Tableau to effectively communicate key insights to operational and clinical leaders and stakeholders
• Develop and maintain high-quality datasets using SQL within the Clinical Data Warehouse
• Work with external data partners (e.g., Vizient, NHSN, etc.) to ensure data accuracy, design new reports, and resolve data questions
• Become expert in interpreting quality measure specifications (e.g., AHRQ, HEDIS, CMS), work directly across the BMC organization to answer questions on specifications
• Develop and maintain metric datasets for hospital improvement programs and contracts
• Support other Hospital QI initiatives, including high-risk result management, complication and infection tracking, and patient safety incident tracking
• Manage multiple projects and analyses simultaneously while meeting key deadlines and deliverables, and prioritizing time and resources
• Identify and elevate key obstacles for intervention that may jeopardize timelines

Skills on Resume:

• Quality Performance Analysis (Hard Skills)
• Dashboard Creation (Hard Skills)
• Data Set Management (Hard Skills)
• External Partner Coordination (Soft Skills)
• Quality Measure Expertise (Hard Skills)
• Metric Development (Hard Skills)
• QI Initiative Support (Hard Skills)
• Project Management (Soft Skills)