The Quality Improvement Sr. Analyst is responsible for leading and managing Empower’s Quality Tracking Improvement Program (QTIP) as the primary accountability. This role ensures that quality of care across acute residential facilities and value-based providers remains a top-level priority. The Sr. Analyst provides in-depth data analysis of trends and patterns of care, identifying gaps and opportunities for improvement. In close collaboration with Utilization Management, the Analyst evaluates initiatives from both a clinical and ROI perspective, ensuring that Empower’s Brand Standards guide all improvement efforts.
The position also partners with clinical and non-clinical teams, providers, and vendors to achieve measurable improvements in member outcomes, experience, access, and cost. By supporting quality governance and contributing to cross-functional projects, the Analyst helps drive accountability and continuous improvement. Familiarity with NCQA, HEDIS, and CMS quality frameworks is strongly preferred to ensure alignment with national standards and value-based care expectations.
The role incorporates Empower’s Brand Standards as the foundation for ensuring service excellence and holding providers and facilities accountable to those standards.
Duties/Responsibilities
Lead the design, execution, and continuous improvement of Empower’s Quality Tracking Improvement Program (QTIP).
Support the development and maintenance of policies, procedures, and standard work that guide quality operations, including document control and version management.
Provide data and technical support to clinical and non-clinical departments on measure definitions, data capture, and workflow design to help close gaps in care.
Work directly with acute residential facilities and value-based providers to ensure quality of care aligns with Empower Brand Standards.
Conduct in-depth data analysis to identify trends, patterns, and variations in care delivery; produce actionable insights and recommendations.
Collaborate closely with Utilization Management and align with Empower Brand Standards to ensure quality initiatives balance member outcomes, operational effectiveness, and ROI.
Partner with Provider Relations and Network leadership by supplying quality findings and analyses that will provide information related to provider performance reviews, outreach, and action plans.
Develop and maintain dashboards, scorecards, and reports that provide clear visibility into provider and facility performance.
Ensure that all quality efforts are guided by Empower’s service philosophy, focusing on empathy, communication, accountability, and excellence in care.
Partner with Provider Relations to implement targeted outreach and improvement plans with facilities and providers that fall below quality benchmarks.
Support members and provider survey design, execution, and analysis to translate feedback into improvement actions.
Monitor and track vendor deliverables for delegated quality measurement and improvement activities, escalating issues to leadership when necessary.
Prepare analyses and summaries that highlight barriers, potential mitigation strategies, and measurable outcomes to support executive decision-making.
Coordinate and assist with internal audits and readiness reviews to help ensure compliance with state, federal, and accreditation requirements.
Contribute to survey efforts by supporting design, execution, and results analysis for member and provider feedback, with findings shared for action planning.
Support organizational learning by helping create training materials, job aids, and resources to build data literacy and improve skills across teams.
Promote alignment with the Quadruple Aim by supporting projects that enhance member experience, improve population health, reduce costs, and strengthen provider engagement.
Advance organizational data literacy by sharing findings, trends, and improvement opportunities with leadership and teams.
Support alignment with NCQA standards, HEDIS measures, and CMS value-based care programs by maintaining accurate reporting and input into dashboards.
Perform other duties and responsibilities as assigned, with a focus on supporting Empower’s mission and Brand Standards.
Required Skills/Abilities
Advanced data analysis and ability to identify trends, gaps, and improvement opportunities.
Strong knowledge of quality improvement methods, including root cause analysis and small tests of change.
Ability to translate complex data into clear, actionable insights for clinical and operational stakeholders.
Excellent organizational, critical thinking, and communication skills.
Ability to build collaborative partnerships with providers, facilities, and cross-functional teams.
Familiarity with Medicaid, managed care, and behavioral health services preferred.
Education and Experience
Bachelor’s degree in a healthcare-related field required; Master’s degree preferred.
Behavioral health licensure strongly preferred.
Five or more years of experience in a healthcare setting, with at least three years in quality improvement.
Experience in managed care, Medicaid, or Medicare preferred.
Proficiency with Microsoft Office, including advanced Excel.