HEDIS (Healthcare Effectiveness Data & Information Set) Manager
Partners Health Management
2 reviews
Kannapolis, NC 28081
Full-time
Partners Health Management
2 reviews
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Job details
Job Type
Full-time
Benefits
Pulled from the full job description
401(k)
401(k) matching
Dental insurance
Disability insurance
Health insurance
Vision insurance
Full Job Description Competitive Compensation & Benefits Package!
Position eligible for –
• Annual incentive bonus plan
• Medical, dental, and vision insurance with low deductible/low cost health plan
• Generous vacation and sick time accrual
• 12 paid holidays
• State Retirement (pension plan)
• 401(k) Plan with employer match
• Company paid life and disability insurance
• Wellness Programs
See attachment for additional details.
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Office *Location: Flexible for any of our office locations
Projected Hiring Range: Depending on Experience
Closing Date: Open Until Filled
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Primary Purpose of Position: *
This position oversees activities, resources, methods, and procedures to manage and achieve improvement in HEDIS measures. Provide functional and technical knowledge for HEDIS across the organization. Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals.
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Role and Responsibilities: *
• Oversee and manage the annual HEDIS submission.
• Oversee and ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement opportunities.
• Collaborate with internal and external stakeholders to ensure HEDIS initiatives are fully integrated throughout the organization, maximizing opportunity to improve outcomes for members.
• Design, run, and manage the data review process to ensure accuracy and integrity of data reports to meet regulatory and operational requirements.
• Manages preparation for HEDIS data collection, validation audits, data submission.
• In concert with the Quality Committees and cross-functional teams, assists in the design and implementation of programs and projects to improve HEDIS rates.
• Collaborates with the Data Analyst Team to obtain relevant information to track and trend quality indicators.
• Ensures accurate and timely submissions of required filings.
• Responds to follow-up validation questions related to the performance measure submissions.
• Coaches and manages efforts to continuously improve performance and value.
• Work with other department leaders to define and implement their reporting needs regarding HEDIS and serve as a broker of available information. Ensure staff meet the requirements of their reporting departments and that practices are following company standards and HEDIS requirements.
• Manage and coordinate HEDIS internal and external audits, ensuring compliance with NCDHHS contractual requirements and federal regulatory standards
• Provide training and serve in a consultative manner related to HEDIS and HEDIS related needs
• Ensure the organization has the tools and resources necessary to be successful with HEDIS auditing and oversight
• Works closely with HEDIS vendors to ensure measures certified and fully compliant
• Collaborates and serves as the HEDIS liaison with other related partners (internal and external)
• Benchmarks organizational HEDIS performance against others (state and nationally)
• Other duties as assigned
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Knowledge, Skills and Abilities: *
• Excellent communication and interpersonal skills
• Excellent computer skills including proficiency in Microsoft Office products
• Ability to establish and maintain effective working relationships with leadership, staff, stakeholders, state and federal officials as well as other partners
• Ability to effectively plan, organize, direct, coordinate and evaluate business operations including a broad range of diverse functions
• Ability to exercise sound judgment, make effective decisions and resolve problems involving complex and sensitive areas
• Ability to recognize and sensitively manage cultural diversity issues and interactions with various and diverse members of staff and the community
• Ability to work collaboratively and effectively to develop processes and protocols, to analyze data and solve problems
• Excellent knowledge and skills related to HEDIS measures and related requirements for HEDIS management, improvement, reporting and auditing
• Ability to take complex data and concisely identify key elements meaningful to convey to various audiences
• Ability to use business intelligence query tools, computer spreadsheet (Excel), and databases at advanced level
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Education/Experience Required: *
Bachelor's degree in Business or Health Care or 4 years commensurate experience; 5+ years’ experience with HEDIS technical specifications.
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Education/Experience Preferred: *
Above, in addition to 2+ years of HEDIS project management or healthcare management experience. Quality improvement experience.
Job Type: Full-time
Hiring Insights Job activity Posted 2 days ago