The Quality Data Validation Analyst is responsible for improving the quality and completeness of
data used for Partnership’s Healthcare Effectiveness Data Information Set (HEDIS) reporting
initiative. This position will focus on sets of measures required by federal and state regulatory
bodies and collaborates with internal and external stakeholders to improve the exchange of clinical
data that meets the requirements for use in the reporting and ensures that services completed within
Partnership’s provider network are accurately leveraged in the HEDIS Project. This position is a
key stakeholder on Partnership’s implementation of a Data Aggregator vendor solution and will
partner with the vendor and internal stakeholders to maximize the impact of the Data Aggregator
solution on HEDIS rates.

▪ Understands and improves data sources and data exchange pathways for HEDIS measures,
working collaboratively with Partnership departments (IT, QI, Finance, Claims, Health
Services, Analytics teams) and external stakeholders (Partnership provider network, County
DPH’s, DHCS, contracted vendors).
o Identifies and quantifies issues and points of failure that prevent completed services
within the provider network from impacting measure rates.
o Proposes and leads initiatives to resolve identified data exchange issues, in
collaboration with multiple internal and external stakeholders.
o Leads evaluation of initiatives to resolve clinical data exchange issues to improve
measure performance.
▪ As Subject Matter Expert on Data Aggregator vendor solution, participates in strategic
planning around implementation across the provider network and across measures for the
Medicaid and Medicare lines of business.
▪ Analyzes plan-wide, county, regional, and practice level trends in measure performance.
▪ Develops analytic tools, methodologies and communication strategies to monitor data
exchange around key quality measures, in collaboration with QI, Regional leadership, Claims,
and other Partnership departments,
▪ Creates and maintains thorough and consistent documentation of data exchange tools and
methodologies.
▪ Communicates information about clinical data exchange and impacts on measure performance
to internal and external stakeholders.
▪ Stays up to date on changes in federal and state reporting requirements and specifications,
vendor landscape around HEDIS, and NCQA initiatives.
▪ Participates in special projects as needed.

All HealthPlan employees are expected to:

• Provide the highest possible level of service to clients;
• Promote teamwork and cooperative effort among employees;
• Maintain safe practices; and
• Abide by the HealthPlan’s policies and procedures, as they may from time to time be updated.

HIRING RANGE:

$118,518.94 - $154,074.63

IMPORTANT DISCLAIMER NOTICE

The job duties, elements, responsibilities, skills, functions, experience, educational factors and the requirements and conditions listed in this job description are representative only and not exhaustive of the tasks that an employee may be required to perform.  The employer reserves the right to revise this job description at any time and to require employees to perform other tasks as circumstances or conditions of its business, competitive considerations, or work environment change.