Quality and Compliance Analyst

Job Summary: The Quality and Compliance Analyst, reporting to the Director of Quality and Compliance. This role is responsible for supporting the implementation and oversight of quality improvement initiatives and ensuring the PACE program's compliance with federal, state, and internal regulations. This role involves data collection, analysis, and reporting related to the program's clinical and operational performance. The analyst works closely with the program's interdisciplinary team (IDT) to evaluate processes, identify areas for improvement and implement strategies to enhance service delivery. Key Responsibilities: 1.Quality Assurance: Collect, analyze, and interpret data related to key quality metrics (e.g., participant outcomes, care delivery processes, readmissions, and medication errors). Assist in developing, implementing, and advancing goals of quality improvement in collaboration with clinical and operational staff. Conduct regular audits and assessments, identifying trends and making recommendations. 2.Regulatory Compliance: Monitor and analyze compliance with relevant laws, regulations, and industry standards, including but not limited to Service Determination Requests, Grievances, Provision of Services, Root Cause Analysis and reporting to the Health Plan Monitoring System. Prepare compliance reports and work with teams to address any identified gaps. Support the organization in preparing and participating in State and Federal audits. 3.Data Management and Analysis: Collect, clean, and manage large data sets from various sources to ensure accuracy and integrity. Analyze data to identify trends, root causes, and areas for improvement Develop and maintain dashboards that visualize key performance indicators (KPIs). Collaborate with departments to streamline data collection and reporting processes. 4.Data Visualization and Reporting Utilize data visualization tools (e.g., Tableau, Power BI, or similar) to create engaging and informative dashboards that facilitate data-driven decision-making. Present findings and insights to stakeholders through clear and concise reports. Support optimization of reporting available through the organization's electronic medical record. 5.Training and Support: Provide training and guidance on quality initiatives, regulatory requirements, and best practices for compliance. Support staff and participants in understanding protocols and compliance-related changes. 6.Documentation: Maintain comprehensive documentation of quality assurance and compliance activities, including policies, procedures, and audit findings. 7.Stakeholder Engagement: Liaise with internal and external stakeholders, including regulatory bodies to ensure effective communication and resolution compliance issues. Qualifications: Education: Bachelor's degree in business administration, quality improvement, data science, accountable care organizations, or a related field required. Experience: Minimum of 2-3 years of experience in quality assurance, compliance, or data analytics role, preferably within a PACE, Medicare, or managed care environment. Skills: Strong knowledge of quality management systems (e.g., ISO, Six Sigma) and regulatory compliance frameworks. Proficient in managing and analyzing large data sets using tools such as Excel, SQL, or Python/R Experience in developing and maintaining interactive dashboards using data visualization software (e.g., Tableau, Power BI, Qlik). Experience working with an electronic medical record. Detailed oriented with excellent organizational and project management skills. Strong communication skills, both verbal and written, with the ability to effectively present data and improvement initiatives to diverse audiences. Proficiency in Microsoft Office Suite and experience with healthcare data management software (e.g., EMRs, quality management tools). Physical Requirements: Ability to sit for extended periods, use office equipment, and communicate effectively in person and over the phone. Occasional travel to PACE centers or training events may be required. Apply Job!