Healthcare HEDIS Reporting Lead

Remote Full-time
Job Overview: The Healthcare HEDIS Reporting Lead implements Healthcare Effectiveness Data and Information Set (HEDIS) project plan and meets all requirements of National Committee for Quality Assurance ( NCQA) and regulatory reporting, which includes project monitoring, data collection, quality control, and final reporting. This role applies both business knowledge and technical expertise to supports HEDIS strategies, goals, and initiatives at corporate and plan level. Work Schedule: • Remote. • Monday through Friday from 8:00a EST to 5:00p EST. Responsibilities: • Develop and manage the annual HEDIS project plan inclusive of HEDIS based regulatory reporting for the enterprise. • Support HEDIS onsite audit. • Facilitates relationship with Medical Record Review (MRR) vendor for all technical aspects of annual MRR projects. • Represents HEDIS team in collaboration with internal departments for HEDIS improvement. • Supports 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 represented and reported accurately for data completeness. • Improves HEDIS reporting process by leading ongoing "lessons learned" processes for internal operational improvement. • Provides managerial guidance to HEDIS Analysts and HEDIS Analysts Sr.'s with meeting deliverables. • Leads ongoing enhancements to the department's HEDIS analytics offerings and solutions. • Effectively translates goals into actionable work plans for individual staff. • Deals proactively and tactfully with difficult customers, viewing such situations as opportunities to continually build stronger working relationships. • Adjusts readily to changing priorities and assignments, and manages staff workload accordingly. Education & Experience • Bachelor's Degree required in Business Management and/or Information Systems • Minimum 3 years working experience in the healthcare industry. • Minimum 1 year of Project Management and HEDIS knowledge required. • Strong SQL and big data / cloud programming skills preferred. • Extensive knowledge of Microsoft Office. • Ability to manage multiple, complex projects with strict deadlines. • Excellent verbal and written communication skills. • Attention to detail and strong organizational skills. Your career starts now. We're looking for the next generation of health care leaders. At AmeriHealth Caritas, we're passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we'd like to hear from you. Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com. Our Comprehensive Benefits Package Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more. Apply tot his job
Apply Now

Similar Opportunities

Experienced Registered Behavior Technician for In-Home ABA Therapy - Atlanta, GA

Remote Full-time

Immediate Hiring: Experienced Registered Behavioral Technician (RBT) for Clinic-Based ABA Therapy Services

Remote Full-time

Experienced Registered Behavioral Technician (RBT) - ABA Therapy for Children with Autism Spectrum Disorder

Remote Full-time

Experienced Registered Nurse - Telehealth: Providing Remote Care Coordination and Patient Support

Remote Full-time

Experienced Substitute Teacher for Riverside County Schools - Join Scoot Education's Innovative Team

Remote Full-time

Experienced Substitute Teacher for San Bernardino County - Flexible Schedules & Competitive Pay

Remote Full-time

Experienced School Year Instructional Coach for High-Dosage Tutoring Programs in Edgewater Park, NJ

Remote Full-time

Experienced School Year Tutor for K-8 Students in Math and Literacy - Mickleton, NJ

Remote Full-time

Experienced Secondary Social Studies Teacher for Kansas - Flexible Hybrid Remote Arrangement

Remote Full-time

USPS Office Helper

Remote Full-time

Sr. Provider Relations Representative - CGS

Remote Full-time

Project Controls Analyst

Remote Full-time

**Part-Time Customer Support Representative – Flexible Hours at arenaflex**

Remote Full-time

Risk Adjustment Medical Coder, Fully Remote

Remote Full-time

Experienced Customer Service Agent - Work from Home Opportunity with blithequark

Remote Full-time

Experienced Sales Relief Supervisor – Leading Customer Relationship Management and Sales Operations in a Dynamic Beverage Industry Environment

Remote Full-time

Remote -SAP Project Manager SAP S/4 -with Pharma Domain-C2C- CH

Remote Full-time

Senior Director Product Management

Remote Full-time

**Experienced Data Entry Agent – Full-Time & Part-Time Opportunities at blithequark's E-commerce Store**

Remote Full-time

Security Architect (Identity & Access Management)

Remote Full-time
← Back to Home