The Quality of Care (QAC) Analyst serves as a key advisor on continuous quality assurance and improvement strategies in the managed care delivery system.
This position participates in the development of program administrative rules and contractual requirements that deal with complex regulatory situations in which policy is not clearly defined.
This position provides consultative advice and direction on administrative, policy, programmatic and management aspects of quality management operations to executive management.
The position ensures adherence to standards for quality and access to care, as defined by federal Medicaid Managed Care regulations, the 1115 Medicaid Demonstration Wavier, state Children’s Health Insurance Plan, and state requirements (e.g., CCO Contract, Oregon Administrative Rules, and Oregon Revised Statutes).
The Quality of Care Analyst provides expert consultation and technical assistance to managed care organizations, community agencies and other key invested partners for identifying innovative approaches to quality care.
This position will collaborate with diverse populations most harmed by social injustice and inequities and will demonstrate the ability to build and steward positive, collaborative and partnership-based relationships with diverse community groups including communities of color, immigrant groups, the disability and neurodivergent communities, veterans, older adults, individuals identifying as LGBTQIA2S+ and other communities that have been traditionally marginalized.
Requirements
A Bachelor's Degree in Business or Public Administration, Behavioral or Social Sciences, Finance, Political Science or any degree demonstrating the capacity for the knowledge and skills; and four years professional-level evaluative, analytical and planning work.
Any combination of experience and education equivalent to seven years of experience that typically supports the knowledge and skills for the classification.
Experience supporting the development and implementation of policies and programs at the community, state, and/or national level that advance health equity (address systemic health disparities, expand culturally responsive and inclusive services, factor in social determinants of health) and elevate the voice of community and those with lived experience.
Knowledge of health services delivery systems, particularly the Oregon Health Plan/ Medicaid administration in Oregon, including experience working with Coordinated Care Organizations, social safety net programs, health service providers (including Community Mental Health Programs and other behavioral health service providers), or community-based organizations.
Knowledge of legislative and regulatory processes; experience analyzing, applying and advising on relevant federal and state Medicaid laws and regulations, including Medicaid Managed Care regulations; specific knowledge of Oregon Administrative Rules and Oregon Revised Statutes is valued.
Ability to foster inter-and cross-agency collaboration and to facilitate coordination of community centered policies, programs, and continuous (quality / process) improvement strategies.
Strong oral and written communication skills across a variety of forums; experience communicating qualitative and quantitative information, verbal and written, that are accessible to and understood by audiences with different levels of comprehension or interest and that are culturally responsive, inclusive, and appropriate.
Experience and knowledge evaluating and synthesizing quantitative and qualitative data to analyze and measure the effectiveness, efficiency, and impact of administrative and technical programs within the context of health policy / healthcare services.
Certification in healthcare quality, compliance, or risk management is valued.
Experience presenting and articulating the value and relevance of research and evaluation data to facilitate quality assurance, strategic planning, and decision-making.
Demonstrated project management experience, including ability to effectively manage multiple project timelines and priorities and promote human-centered change management.
To be hired, you must have a criminal records and driving records check that meets OHA criteria at the time of hire, and throughout employment.
Benefits
Excellent medical, vision, and dental benefits package for the employee and qualified family members with a very low monthly out-of-pocket cost.
Optional life insurance, short-term disability, long-term disability, deferred compensation savings program, and flexible spending accounts for health care and childcare expenses.
Employee benefits include 11 paid holidays, 3 personal business days, 8 hours of monthly sick leave, and vacation accrual starting at 8 hours per month.
Possible eligibility for the Public Service Loan Forgiveness Program.
Membership in the Public Employees Retirement System (PERS)/ Oregon Public Service Retirement Plan (OPSRP).
Training opportunities that will help grow your career with the State of Oregon.
Job title
Quality of Care Analyst – Operations & Policy Analyst 3
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