Key skills
Health services researchHealth policy researchQuality measurementMedicare and Medicaid payment modelsClinical measure evaluationAdministrative claims dataElectronic health records (EHR) dataMeasure developmentProposal writingBusiness developmentData analysisClient engagementRepositoryLeadership
About this role
Optum is a premier national health care and human services consulting firm seeking a Senior Consultant for Quality Measurement. The role involves evaluating clinical measures, developing testing protocols, and managing client relationships to support quality measurement initiatives for Medicare and Medicaid.
Responsibilities:
- Evaluate evidence on effectiveness for clinical measures derived from administrative or claims data, health records, electronic health records, other data sources in compliance with Centers for Medicare & Medicaid Services (CMS), the Agency for Healthcare Research and Quality, and the National Quality Forum (NQF) requirements
- Develop test measure protocols and measure specifications
- Perform a broad range of quantitative analysis to inform quality measurement for Medicare and Medicaid payment models
- Track activities of key standards-setting committees and consensus-based organizations such as NQF
- Draft and manage proposals for new projects related to measure development, testing, maintenance, and implementation
- Engage, develop, cultivate and expand new and existing client relationships through policy consultation and thought leadership
- Support the continued development of existing strategy to fuel long-term organizational growth in partnership with organizational leadership
- Manage project delivery teams responsible for day-to-day project execution
- Mentor other team members to develop their technical and analytical problem-solving skills
Requirements:
- Health policy professional with 6+ years industry experience in health services research, evaluation and/or policy including strong analytic skills and advanced degree (M.D., D.O., Master's degree, or Ph.D.) in medicine, economics, health policy research, or similar discipline OR a Bachelor's degree with 8+ years of experience
- Experience in leading business development and proposal response efforts, including engaging with clients and partners in the business development process
- Broad understanding of federal or state health policy issues, with ability to work in multiple areas serving as a subject matter expert
- Experience working on quality measure engagements, preferably for federal programs, including those at CMS
- Experience working with various types of data used to measure health care quality (e.g., administrative claims, instrument-collected data, chart-abstracted data, EHR output)
- Experience collaborating with and building consensus with diverse teams ability to communicate with individuals of varying technical aptitudes and professional backgrounds
- Experience supporting multi-year quality measure development or implementation contracts
- Experience with databases having complex structures and relationships, such as the Integrated Data Repository, Chronic Conditions Warehouse, or similar data environment