Responsibilities of the Manager, HEDIS Reporting:
Manages Healthcare Effectiveness Data and Information Set (HEDIS) planning, data collection, quality control, analysis, and reporting to meet all requirements of National Committee for Quality Assurance (NCQA) and regulatory. Applying both business knowledge and technical expertise to supports HEDIS strategies, goals, and initiatives at the corporate and plan-level.
Essential Functions include but not limited:
- Must be proficient in SQL programming to manage a team of SQL programmers.
- Leads staff in all aspects of HEDIS operations required to meet NCQA submission requirements.
- Manages HEDIS/CAHPS auditing process including preparation of 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.
- Develops and manages annual HEDIS project plan and the appropriate protocols of “chase logic.”
- 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.
- Serves as a team member for activities focused on HEDIS performance improvement.
- Analyzes HEDIS results and identifies HEDIS performance improvement opportunities.
- Anticipates and meets, or exceeds, internal and/or external customer expectations and requirements; establishes and maintains effective relationships with customers and gains their trust and respect
- Other duties as assigned with or without accommodation.
Management Responsibilities:
- Hires participates in and/or recommends development measures and disciplinary actions up to and including termination, evaluates performance, and supervises the work of all direct and indirect reports following established organizational policies, procedures, and practices.
- Motivates and encourages staff; leads through change and adversity. Makes decisions as needed and builds consensus as to appropriate. Communicates and cascades information to employees in a timely manner and actively participates in the success of cross-organizational programs and initiatives.
- Sets clear goals and objectives and uses metrics to measure performance and hold staff accountable. Provides coaching to improve performance and holds regular development discussions with direct reports. Recognizes staff for their contributions.
Requirements of the Manager, HEDIS Reporting:
- Bachelor’s Degree in HealthCare related degree required
- Master’s Degree preferred in Public Health or Business Management
- Minimum 5 years of working experience in the health care industry.
- Minimum 2 years of HEDIS project management and data collection experience required.
- Extensive knowledge of Microsoft Office and SQL programming.
- Ability to manage multiple, complex projects with strict deadlines.
- Excellent verbal and written communication skills.
Benefits of the Manager, HEDIS Reporting:
- Medical Insurance
- Dental Insurance
- Vision Insurance
- Life Insurance
- Short Term / Long Term Disability
Company Description:Relevante is an innovative recruiting, staffing, and consulting firm. We help our clients find the best talent for their mission-critical positions and we help candidates find rewarding and enriching careers. Our consultative approach to solving resourcing challenges for our clients is driven by our industry-specific knowledge, our strong recruiting capabilities, and our agility.
We support our clients’ goals through results-driven execution, planning, and management of accounting and technology initiatives. Relevante’s resourceful and responsive teams bring deep technology and accounting expertise, thought leadership, and business-relevant solutions to each and every partnership. Our clients appreciate our can-do attitude, value our results, and keep coming back.
Founded in 2002, we have grown through a culture of operational excellence, a passion for client satisfaction, technology innovation, and a global, collaborative workforce that embodies the future of work. Our success is built on a clear strategic direction and a shared belief in its ability to shape your business landscape and accelerate business growth.