HEDIS Analyst

Amerihealth Administrators   •  

Baton Rouge, LA

Industry: Managed Care & Health Insurance


5 - 7 years

Posted 325 days ago

  by    Gab Spadea

**Can be office or remote position!

But Candidate Must Travel to one of the local offices which are located near:

Newark, NJ

Harrisburg, PA

Baton Rouge, LA

Reston, VA

Charleston, SC

Philadelphia, PA

Job Description

We have partnered with a large Health Insurance company in the Philadelphia, PA area to provide them with a HEDIS Analyst.

Please review the below description and if you are interested please contact:

  • Gaby Spadea at gespadea@gmail.com


Job Summary:

Supports corporate, plan-level, and departmental strategies and goals for HEDIS process. Meets this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems.

**Telecommuting permitted for qualified candidates.   

Education & Experience:

  • Bachelor’s degreerequired with a concentration in health care related field; Master’s degree is preferred
  • Minimum 2years’ experience with HEDIS preferred.
  • Minimum 5years of work experience in healthcare and/or managed care
  • Other skills:SQL and / or SAS experiencerequired

Essential Functions include but not limited:

  • Manage the HEDIS lifecycle process for multiple plans.
  • Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations. 
  • In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs.
  • Assist in preparation for the HEDIS audit.
  • Develop and maintain HEDIS based report tosupport Quality Initiatives.
  • Represent HEDIS team in collaboration with internal departments for HEDIS improvement.
  • Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.
  • Assists as necessary in the HEDIS Road Map and all other documents required by auditors.
  • Able to assimilate into team within minimum amount of assistance 
  • Assures the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers.
  • Experience and ability to utilize a certified HEDIS software.