Clinical Outcomes Analyst

Location US-CA-Los Angeles
Job ID


The Clinical Outcomes Analyst is responsible for providing support for performance measurement, data analytics, and internal and external HEDIS and quality reporting. Major responsibilities include developing analytic reports on a regular and ad hoc basis to assist in identifying clinical outcomes., tracking specified patients/populations and conditions that assist in the clinical and cost management of these patients, supporting quality improvement projects and initiatives, measuring outcomes of programmatic interventions as needed, reviewing literature for relevant background information, performing data analyses and working collaboratively with health plan partners to improve clinical quality performance rates. Produces regular monthly, quarterly, and annual reports for internal and external customers.



  1. Responsible for the oversight of accuracy of quality reports, requesting report or EHR code changes as needed, and ensuring data/reports are compliant with current NCQA and IHA HEDIS specifications.
  2. Become EHR "super user" and assist organization in improvement of data capture, EHR workflows, and health plan reporting.
  3. Create, run, analyze and distribute routine and ad hoc quality reports.
  4. Monitor health plan quality results; conduct routine audits/validation of health plan data to address low performing measures.
  5. Meet with health plan partners routinely to review performance reports, discuss barriers to success, and develop improvement plans.
  6. Assist in self-reporting process; update HEDIS Road Map and policies and procedures as needed
  7. Data analysis and root cause analysis to identify and prioritize opportunities for quality improvement
  8. Keep abreast of industry changes on programs affecting quality, disease management and incentive programs.
  9. Maintain and submit necessary forms, applications, program descriptions, data, and reporting necessary for outside agencies (i.e. regulatory requirements, incentives, recognitions/certifications).
  10. Provides technical assistance, consultation, coordination and education activities; evaluate departmental programs and services.
  11. Perform process and workflow mapping as needed
  12. Establish and promote ongoing collaboration and coordination with health plans, community agencies, health and social service providers and professional associations at local and state levels.
  13. Performs all other related duties as assigned.



  1. Bachelor’s degree required.
  2. A minimum of one year experience in HEDIS, quality improvement, or related experience preferred.
  3. Process improvement experience/certification (LEAN, Six Sigma) preferred.
  4. Experience with health plan and/or IHA reporting preferred.



Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
Share on your newsfeed

Connect With Us!

Not ready to apply? Connect with us for general consideration.