HEDIS Analyst Senior (REMOTE)

We have partnered with a large Health Insurance company in the Newtown Square, PA area to provide them with a HEDIS Analyst Senior. (REMOTE)

Please review the below description and let us know if you are interested. 

Responsibilities of the HEDIS Analyst Senior:

Responsible for the support, maintenance, and developmental strategies for HEDIS throughout our client. Ensures the maximum level of data accuracy, integrity, consistency, and completeness in the various internal and external data sources used for end-user reporting purposes (e.g., Oracle data warehouses, various supplemental data sources).  Identifies data-related issues, and conducts root cause analyses; facilitates resolution of known issues by working directly with end-users and IT staff.  Works closely with the Quality Team and Medical Record Review (MRR) team to support annual MRR projects (i.e. understanding and configuration of provider chase logic, interfacing of data with MRR project vendors).  Assist as needed in the creation and support of the Roadmap, HEDIS audit, and various HEDIS reports including QA.   Establishes business rules for accurate use of reporting data fields.  Identifies new and maintains existing sources of data to ensure the availability of information for reporting purposes.  Generates and maintains thorough and accurate documentation related to data, databases, business rules, and reporting policies and procedures for all LOBs.  Develops and executes test processes related to end-user data and databases; documents and tracks data-related issues, and facilitates resolution of such issues.  Supports identification of training opportunities and assist in mentoring and training associates in regards to the HEDIS process and timeline. The position interacts with associates at all levels in the organization, external clients, and vendors.                                                                                        

• Manage the HEDIS lifecycle process for multiple plans.
• Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations. 
• Develops and implements data-driven solutions to meet business requirements by producing analytics, reports, and data sets.
• Collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs.
• Assist in preparation for the HEDIS audit.
• Develop and maintain HEDIS based reporting to support Quality Initiatives.
• Represent HEDIS team in collaboration with internal departments for HEDIS improvement.
• Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.
• Assists as necessary in the HEDIS Road Map and all other documents required by auditors.
• Able to assimilate into a team with a minimum amount of assistance. 
• Assures the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers.
• Experience and ability to utilize certified HEDIS software.
• Experience working with Medical Record Review vendors is a plus.

Requirements of the HEDIS Analyst Senior:

• Bachelor’s Degree; Master’s Degree preferred.
• Required with a concentration in a healthcare-related field.
• Minimum 2 years HEDIS experience required, 4 years preferred.
• Minimum 5 years of work experience in healthcare and/or managed care.
• SQL experience required.
• Experience writing queries in a cloud / big data environment is a plus (i.e. working with Hadoop/HUE, Snowflake, etc.). 
• Experience utilizing certified HEDIS software.

Benefits of the HEDIS Analyst Senior:

• Medical Insurance
• Dental Insurance
• Vision Insurance
• Life Insurance
• Short / Long Term Disability
• 401 (k) – Profit Sharing

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.

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