
Accomplished Sr. Analyst at Aetna/CVS, adept in data analysis and client relationship management. Excelled in developing quality assurance programs, enhancing healthcare outcomes by implementing strategic process improvements. Proven track record in conducting rigorous audits, leading to significant compliance advancements. Skilled in delivering impactful training on quality and safety, demonstrating a commitment to excellence and stakeholder engagement.
Primary Job Duties & Responsibilities:
Analyzes and interprets complex Quality-associated data related to healthcare quality measures, patient outcomes, and performance indicators.
Develops complex quality assurance programs to ensure strict compliance with all applicable regulatory requirements, accreditation standards, and industry best practices.
Conducts routine audits and assessments to evaluate ongoing adherence to company-established quality standards and identifies core areas for improvement.
Examines and reports on quality measures, patient safety indicators, and other performance indicators to identify areas of success and areas for improvement.
Coordinates complex process mapping, root cause analysis, and workflow redesign to optimize healthcare processes and reduce errors and inefficiencies.
Applies in-depth knowledge and experience in conducting external audits and surveys related to quality and compliance.
Completes reports and presentations to communicate findings and recommendations to stakeholders, including senior management, quality improvement teams, and regulatory bodies.
Designs and delivers comprehensive training programs related to quality improvement, patient safety, and regulatory compliance.
Provides education and guidance to staff members on quality standards, performance measurement, and process improvement methodologies.