Senior Associate, Quality Data

Job Description:

Job Description

The Senior Associate, Quality Data works the Manager, Quality Data to own and maintain Cityblock’s quality data infrastructure, supporting proper data ingestion and transformation (‘Data In’) as well as quality gap segmentation and evidence submission (‘Data Out’). Key activities can include: overseeing and auditing incoming and outgoing Quality-related data pipelines between Cityblock and payer partners; managing and expanding Cityblock’s use of external clinical data pipelines (ADT Notification, Lab Result, Medication Dispense, Medical Records, etc.) to drive quality measure performance improvement; maintaining a mastery of technical and clinical specifications across HEDIS / Medicare Stars quality measures and Cityblock’s quality contracts; serving as a subject matter expert to Cityblock’s Tech and Clinical organizations on Quality Data requirements and opportunities; providing actionable insights on quality gap performance and closure opportunities to frontline care teams and managers.

Responsibilities

• Oversee the intake, validation, and management of quality data from all payors, ensuring accuracy, completeness, and timeliness; use SQL to perform preliminary investigation of data issues and lapses directly in Cityblock data warehouses / data lakes, and partner with Quality Strategy, Partner Success, and/or Tech to remediate
• Partner with Client Reporting and Analytics to establish, audit, and submit supplemental clinical data files for all payors in compliance with HEDIS/NCQA, CMS, and payer contractual requirements, with clear data provenance for all submitted records
• Leverage Cityblock’s broad clinical data to develop suspecting algorithms that predict opportunities for gap closure and/or exclusion via medical records research; support the Quality Research team in researching these opportunities
• Test quality data models, make targeted modifications as needed, and independently analyze large datasets to surface underlying trends in gap performance, without relying on other teams for routine analysis
• Collaborate with the Network & Partnerships team as well as external chart retrieval vendors, in order to secure access to primary-source medical records that support quality gap closure and/or exclusion
• Partner with the Manager, Quality Operations as well as frontline care team managers and clinical leadership to ensure provider and care team documentation meets HEDIS standards and supports effective gap closure; work with these partners to surface and remediate documentation gaps
• Collaborate with Quality Analytics and Quality Operations to ensure quality performance reporting, dashboards, and operational workflows are aligned with HEDIS/NCQA and CMS standards for gap closure
• Support quality tooling and technology implementations, ensuring proper validation, quality checks, and effective use across the organization while contributing to a high-performing, collaborative Quality team.
  

Requirements

• 3+ years of experience focused on healthcare domains such as quality improvement, population health, care management, and/or risk adjustment
• Proficiency in SQL for querying, validating, and analyzing datasets too large to work with in spreadsheet tools (e.g. Google Sheets), including testing and modifying data models
• Ability to interpret BI / visualization tools (e.g. Looker, Tableau, Power BI) and use them to analyze data and identify trends
• Experience with a scripting language (e.g. Python, R) for data wrangling, exploratory data analysis, and light automation, including developing suspecting logic
  

Nice-to-Have:

• Strong preference for experience with HEDIS / Medicare Stars quality programs
• Experience with value-based care reimbursement models, and/or experience with government-sponsored/regulated lines of business (Medicare, Medicaid, ACA Exchange)

We take into account an individual’s qualifications, skillset, and experience in determining final salary. This role is eligible for health insurance, life insurance, retirement benefits, participation in the company’s equity program, paid time off, including vacation and sick leave. The actual offer will be at the company’s sole discretion and determined by relevant business considerations, including the final candidate’s qualifications, years of experience, skillset, and geographic location. The expected salary range for this position is:

$80,000 - $102,000

Cityblock values diversity as a core tenet of the work we do and the populations we serve. We are an equal opportunity employer, indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

We do not accept unsolicited resumes from outside recruiters/placement agencies. Cityblock will not pay fees associated with resumes presented through unsolicited means.

About Us:

Cityblock Health is the first tech-driven provider for communities with complex needs—bringing better care to where it’s needed most, block by block. Founded in 2017 on the premise that “health is local” and based in Brooklyn, we are backed by Alphabet’s Sidewalk Labs along with some of the top healthcare investors in the country.

Our mission is to improve the health of underserved communities. Importantly, our solutions are designed specifically for Medicaid and lower-income Medicare beneficiaries, and we meet our members where they are, bringing care into the home and neighborhoods through our community-based care teams and Virtual Care offerings.

In close collaboration with community-based organizations, local providers, and leading health plans, we are reorganizing the health system to focus on what matters to our members. Equipped with world-class, custom care delivery technology, we deliver personalized primary care, behavioral health, and social services to deliver a radically better experience of care for every member and community we serve.

Over the next year, we’ll grow quickly to bring better care to many more members and their communities. To do this, we need people who, like us, believe that everyone should have good care for what matters to them, in their community.

Our work is grounded in a belief in the power of a diverse community. To close gaps in care and advance equity in the communities we serve, we have to start with making our own team diverse and inclusive. Our ways of working are characterized by creativity, collaboration, and mutual learning that comes from bringing together a community from diverse backgrounds and perspectives. We strive to ensure that every person on the Cityblock team, and every Cityblock member, feels supported and included as a part of our community.

Our Values:
Aim for Understanding
Be All In
Bring Your Whole Self
Lean Into Discomfort
Put Members First

About our Team:
We employ a field-based, home-based care model and are committed to meeting members where they are--in their homes, in their community, and in our Hubs. We will go above and beyond to connect with Cityblock members in a non-judgmental, respectful and empathic manner, to meet their needs, and to provide feedback to the system as a whole as we strive to do better every day.