Vendor Quality Control Analyst jobs in District of Columbia

Position Summary:

More than a decade ago, CAQH established the CAQH Committee on Operating Rules for Information Exchange (CORE®) as an industry-wide collaboration committed to the development and adoption of healthcare operating rules for exchange of administrative data.

The CORE Analyst supports the day-to-day activities of the Committee on Operating Rules for Information Exchange (CORE), an initiative of CAQH. This person conducts analysis and research on interoperability topics with a focus on value-based care. The CORE Analyst assists with CORE work groups which includes representatives from health plans, providers, vendors/clearinghouses, financial institutions, industry associations, and government entities. This person curates information relevant to the design, administration and evolution of value-based care programs and supports CORE’s policy efforts. 

The CORE Analyst is a full-time, remote, exempt position and reports to the Associate Director, CORE.

Specific Responsibilities:

• Research, design, and draft content for industry work groups, which develop and maintain healthcare interoperability solutions. 
  1. Assist Associate Director with the development of analysis strategies, research summaries, CORE work group facilitation documents, and draft recommendations, in collaboration with subject matter experts. 
  2. Proactively identify aspects of value-based care programs that could benefit from solutions to streamline data exchange, standardization, or adoption.
  3. Draft critical tools to assist the industry with implementation and maintenance of the CORE Operating Rules.

• Support execution of project plans and daily management of industry work groups. 
  1. Develop work group meeting management materials including work plans, rosters, schedules, agendas, meeting summaries, task lists, etc. 
  2. Organize and track work group progress, update work plans as needed, and identify and communicate any impacts of updates to schedule or scope.
  3. Provide scheduling, logistical oversight, and meeting organization for work groups and related meetings (e.g., Co-Chair prep calls, research calls, etc.).
  4. Proactively provide recommendations to optimize workflows to the Associate Director as needed.

• Provide ongoing support for CORE policy and implementation efforts. 
  1. Work collaboratively with CORE team to develop tools to assist the industry with implementation and maintenance of the CORE Operating Rules. 
  2. Provide timely responses to industry questions regarding operating rule requirements, implementation, resources, and work group activity. Escalate significant issues to appropriate staff and develop recommendations for organizational enhancements.
  3. Create initial drafts of presentation materials for external presentations.
  4. Conduct research in preparation for multi-stakeholder calls/meetings or for regulatory/policy-related meetings with federal agencies and advisory committees. 

• Present information relevant to the design and administration of value-based care programs.
  1. Seeks out and reads through program materials, flagging potential opportunities for operating rule and solution development for discussion and scoping with Associate Director.
  2. Attend relevant industry webinars, work groups, and other meetings as identified and assigned, collating relevant information for presentation and consideration to the CORE team.
  3. Working with the Associate Director, identify how existing and emerging standards, regulations, and legislation aligns and impacts the adoption and implementation of value-based care.

Supervisory Responsibilities:

None.

Skills: 

• Fundamental understanding of value-based care and payment methods.
• Ability to review complex government regulation / legislation and requests for information (RFIs), proactively synthesize key aspects, and draft responses on behalf of CORE.
• Ability to carry-out environmental scans of industry topics and concisely present opportunities for standardization to CORE leadership to gain buy-in and collaboration.
• Strong analytic capabilities to compile and interpret data for trends, market changes, intersection with other related initiatives.
• Ability to proactively learn new and challenging content areas and distill information to broader audiences.
• Ability to simultaneously perform multiple assignments and follow extensive work plans.
• Excellent attention to detail and organizational skills.
• Excellent writing skills with the ability to translate into formal presentations as needed. 
• Excellent interpersonal communication skills and collaborative spirit.
• Experience in Microsoft Word, PowerPoint and Excel.
• Experience with survey software, e.g., Survey Monkey or Qualtrics, and/or CRM software desired.

Experience:

• Two years of related work experience in the healthcare industry, preferably in healthcare policy or consulting. 

Education:

• Bachelor’s degree required; business, policy and technology disciplines preferred.
• Master's level class work and/or degree in healthcare policy, healthcare administration, public policy or a related field desirable.

WHO WE ARE

Named one Modern Healthcare’s “Best Places to Work,” CAQH has helped nearly 1,000 health plans, 2 million providers, government entities and vendors connect, exchange information and operate more efficiently. CAQH technology-enabled solutions and its Committee on Operating Rules for Information Exchange (CORE) bring the healthcare industry together to make sharing business information more automated, predictable, and consistent. CAQH Insights researches opportunities to reduce the burden of manual processes in healthcare administration.  

WHAT YOU GET

CAQH recognizes that its most important asset is its growing team of smart, creative, collaborative, forward-thinking and passionate professionals – and that a comprehensive employee benefits package is an important factor for them in choosing where to work. CAQH offers competitive compensation along with an extensive benefits package for all full-time employees, including medical, dental and vision coverage, tuition assistance and a 401k. We offer full-time remote work to all staff from any location and maintain a physical office in downtown Washington, DC.

At CAQH, we are proud of our active commitment to Diversity, Equity, and Inclusion (DEI). Our DEI committee works diligently to foster an inclusive workplace where all individuals are valued, respected, and empowered. We embrace diverse perspectives and are dedicated to providing equal opportunities for everyone to thrive. Join us in our mission to transform healthcare through innovative technology solutions while making a positive impact on the lives of diverse communities.

CAQH is an equal opportunity employer. It is our policy to recruit, hire, train, and promote individuals, as well as administer any and all personnel actions, without regard to race, color, religion, sex, national origin or ancestry, age, marital status, disability, protected veteran status, personal appearance, sexual orientation, gender identity or expression, familial status, family responsibilities, matriculation, political affiliation, genetic information, source of income, place of residence, or any other characteristic protected by law. CAQH will not tolerate any unlawful discrimination and any such conduct is strictly prohibited.

Applicants have rights under the Family Medical Leave Act (FMLA), Equal Employment Opportunity (EEO), and the Employee Polygraph Protection Act (EPPA). If you are interested in applying for employment with CAQH and need an accommodation to apply for a posted position, contact CAQH Human Resources at 202-517-0436.

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