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.
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.