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Healthcare HEDIS Reporting Lead

AmeriHealth Caritas
Philadelphia, Pennsylvania, United States
November 11, 2016

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

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

Lilit Mkrtchyan at:


Responsible he primary purpose of the job is :

Implementing Healthcare Effectiveness Data and Information Set (HEDIS) project plan and meets all requirements of National Committee for Quality Assurance (NCQA) and regulatory, which includes project monitoring, data collection, quality control, and reporting.

Applying both business knowledge and technical expertise to supports HEDIS strategies, goals, and initiatives at corporate and plan-level.

Principle Accountabilities include but are not limited to:

In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs

Prepare HEDIS onsite audit

Facilitates the relationship with Medical Record Review vendor

Represent HEDIS team in collaboration with internal departments for HEDIS improvement

Prepare HEDIS Road Map and all other documents required by auditors.

Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.

Ensures all HEDIS supplemental data sources are gathered and are completed

Improves HEDIS reporting process by leading a “lessons learned” process for internal operational improvement

Other duties as required and/or assigned

Education & Experience:

Bachelor’s Degree required

Minimum 3 years working experience in the health care industry.

Minimum 1 year of Project Management and HEDIS knowledge required.

Extensive knowledge of Microsoft Office.

Other Skills:

Ability to manage multiple, complex projects with strict deadlines.

Excellent verbal and written communication skills.

Strong desire for accuracy, a concern for detail.

Strong SQL/SAS programming skills preferred.

About Relevante, Inc. – the Recruiting Firm Representing the Client for this Job

Relevante is an accounting & technology direct hire recruiting and contract staffing firm. We help our Clients identify and recruit the best talent in the market and help our candidates win engaging and enriching jobs. Our Clients are some of the best companies to work for among F1000 and emerging fast growth companies in the region. Relevante has been consistently ranked as a fast growth company and one of the largest recruiting, accounting, and management consulting firms in the Philadelphia region.