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