Senior Functional Analyst

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The Company

AlohaCare is a local, non-profit health plan serving the Medicaid and Medicare dual eligible population. We provide comprehensive managed care to qualifying health plan members through well-established partnerships with quality health care providers and community-governed health centers. Our mission is to serve individuals and communities in the true spirit of aloha by ensuring and advocating access to quality health care for all. This is accomplished with emphasis on prevention and primary care through community health centers that founded us and continue to guide us as well as with others that share our commitment. As Hawaii’s third-largest health plan, AlohaCare offers comprehensive prevention, primary and specialty care coverage in order to successfully build a healthy Hawaii.

The Culture

AlohaCare employees share a passion for helping Hawaii’s most underserved communities. This passion for helping and caring for others is internalized and applied to our employees through a supportive and positive work environment, healthy work/life balance, continuous communication, and a generous benefits package.

AlohaCare’s leadership empowers and engages its employees through frequent diversity, recognition, community, and educational events and programs. AlohaCare has a strong commitment to support Hawaii’s families and reinforces a healthy work/home balance for its employees. Because AlohaCare values honesty, respect, and trust with both our internal and external customers, we encourage open-door, two-way communication through daily interactions, employee events and quarterly all-staff meetings. AlohaCare’s comprehensive benefits package includes low cost medical, dental, drug and vision insurance, PTO program, 401k employer contribution, referral bonus and pretax transportation and parking program.

These employee-focused efforts contribute to a friendly, team-oriented culture which is positively reflected into the communities we serve.

Position Summary

The Senior Functional Analyst is responsible for delivering day-to-day analytic support to the Quality Improvement department. This position serves as the technical liaison between the Quality and IT departments and various internal business units and external partners in support of the data management and oversight of HEDIS, Stars, CAHPS, HOS, and other Quality-related reporting.

Primary Job Duties And Responsibilities

• Serves as the subject matter expert on Quality data management and analysis, Quality audit processes, and systems used to meet regulatory, contractual and accreditation requirements.
• For data, manages the Certified HEDIS vendor system and serves as the primary vendor contact; this includes data for HEDIS, CAHPS and HOS files.
• Prepares accurate reports and presents findings.
• Assists with the development, execution, and validation of operational standard and ad hoc reports and makes the required recommendations for maintenance and enhancements.
• Assists in facilitating the completion of the annual HEDIS Roadmap, as needed.
• Prepares and maintains documentation of data logic and criteria related to regulatory and accreditation reports.
• Participates in the management of provider centric information technology projects.
• Works closely with the QI leadership and teams to evaluate and improve business processes and provides recommendations.
• Assists with implementation of system enhancements related to regulatory submissions and data analysis.
• Participates in training for new team members re: systems, tools, and reports.
• Assists with standardized and automated report development.
• Other related duties as assigned.
• Responsible to maintain AlohaCare’s confidential information in accordance with AlohaCare policies, and state and federal laws, rules, and regulations regarding confidentiality. Employees have access to AlohaCare data based on the data classification assigned to this job title.
  
  

Required Competencies & Qualifications

• Bachelor’s degree in a business or healthcare related area of study.
• 2- 3 years’ experience performing data collection, analysis, and management.
• Conducting research and documentation of requirements.
• Knowledge of data governance or data management concepts.
• Working knowledge of healthcare industry.
• Strong verbal and written communication skills.
• Capable of working under tight deadlines, with the flexibility to work on several projects concurrently.
• Advanced skills using Microsoft Programs; Word, Excel, Access, Outlook, and PowerPoint.
• Strong organizational skills.
• Flexibility and adaptability to changing priorities.
• Available for weekend or extra hours work during project implementation or whenever necessary to accomplish tasks.
• Experience managing and analyzing health plan data.
  
  

Preferred Competencies & Qualifications

• Experience with HEDIS and Stars data.
• Health care industry experience within managed care, hospital, medical office or equivalent preferred.
• Knowledge of health research methodology, biostatistics, and medical terminology.
  
  

Physical Demands/Working Conditions

• Inside working conditions.
• No environmental hazards.
• Sedentary Work: Exerting up to 20 pounds of force occasionally and/or a negligible amount of force frequently or constantly to lift, carry, push, pull, or otherwise move objects. Sedentary work involves sitting most of the time but may involve walking or standing for brief periods of time. Jobs are sedentary if walking and standing are required only occasionally, and all other sedentary criteria are met.
  
  

Salary Range: $65,000 - $80,000 annually

AlohaCare is committed to providing equal employment opportunity to all applicants in accordance with sound practices and federal and state laws. Our policy prohibits discrimination and harassment because of race, color, religion, sex (including gender identity or expression), pregnancy, age, national origin, ancestry, marital status, arrest and court record), disability, genetic information, sexual orientation, domestic or sexual violence victim status, credit history, citizenship status, military/veterans’ status, or other characteristics protected under applicable state and federal laws, regulations, and/or executive orders.