Quality Improvement Analyst Sr. Resume

TECHNICAL SKILLS

Statistical Software SAS,
Working knowledge in SQL and DSS
Tableau
MS Office Word, Excel, PowerPoint, Access

PROFESSIONAL EXPERIENCE

Confidential

Quality Improvement Analyst Sr.

Responsibilities:

Responsible for monitoring and reporting on the status of departmental projects: Anticipated and identified issues that could inhibit achieving the project goals and objectives, and implementing corrective actions and mitigation strategies.
Completed 6 month Essentials of Managed Health Care Course
Analyzed key metrics, such as top diagnoses, clinical procedures, and operational performance, Average length of stay, ER Utilization, Readmit Rates and Behavioral Health Metrics in Tableau and excel to enable the development of sound and valid recommendations
Wrote SQL and SAS queries for collecting data (especially claims and eligibility) and summarized performance data and identified opportunities for improvement.
Monitored and analyzed outcomes to ensure goals, objectives, and desired outcomes are achieved.
Assisted in HEDIS measures monitoring and trending analysis both for Medicaid and Medicare
Pursued methods to ensure receipt of data required for trending and reporting of various QI work plan metrics, performed adequate data/barrier analysis, developed improvement recommendations, and deployed actions as approved.
Managed the provider reassignment project that crossed multiple departments for improvement in quality outcomes.
Conducted business analysis and recommended solutions to management as to course of action that best meets the organization's goals
Performed other duties as assigned.

Confidential

Epidemiologist

Responsibilities:

Identify, analyze and interpret trends in complex and large Medicaid data sets using SQL, SAS relational datasets and Tableau for the Managed Care Maternity program in State Medicaid
Provide ongoing interdepartmental communication and monthly or quarterly data reports to CMS
Preparing charts, illustrations, and other graphics and narrative reports to identify and explain patterns and trends
Use database tools to identify, analyze and interpret trends in complex and large data sets using SAS, SQL and Tableau
Data Capture: In collaboration with others develop and maintain and access databases in SQL and data systems necessary for projects and department functions
Acquire and abstract primary and secondary data from existing internal or external sources in SQL
Develop and implement data collection systems and other strategies that optimize statistical efficiency, data quality and data integrity
Data Reporting: In collaboration with others (Alabama Department of Public Health ADPH and Managed Care in Medicaid) interpret data and develop recommendations based on findings, develop graphs, reports and presentations of project results
Perform statistical results for projects and reports; create and present quality dashboards in SAS Visual Analytics
Communicating the analysis results and interpretations to staff, management and other decision makers by interpreting and communicating information orally and written
Identify problematic areas and conduct research to determine the best course of action to correct data; analyze and problem solve issues with current and planned systems as they relate to integration and management of patient data
Analyze reports for data duplication and other errors
Able to prioritize, meet deadlines, manage changing priorities
Working on projects requiring research, critical thinking, analytical and problem solving skills

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