Healthcare HEDIS Reporting Lead

Experience with full HEDIS Road Map and life cycle, SQL skills and previous management experience.

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.

• Remote.
• Monday through Friday from 8:00a EST to 5:00p EST.

• Develop and manage the annual HEDIS project plan inclusive of HEDIS based regulatory reporting for the enterprise.
• 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.

• 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.