Details:
Title: HEDIS Analyst
Location: Philadelphia, PA, 19113
Duration: 3+ Months
Job Description:
Supports corporate, plan-level, and departmental strategies and goals for HEDIS process. Meets this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems.
Essential Functions include but not limited:
- 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.
- In 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 report 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 team within 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 a certified HEDIS software.
Requirements:
- Minimum 1 year HEDIS experience required, 2+ years preferred.
- Minimum 5 years of work experience in healthcare and/or managed care
- Bachelor’s Degree required with a concentration in health care related field; Masters Degree preferred
Other Skills:
- SQL and SAS experience required