Senior Hedis Analyst (Remote)

Salary: $ 90,000.00

We have partnered with a large Health Insurance company in the Newtown Square, PA area to provide them with a Senior HEDIS Analyst. (REMOTE). Please review the below description and let us know if you are interested.

Prioritized Must Have Skills For The Senior HEDIS Analyst

#1. Bachelor's Degree Required

#2. Minimum 1 year HEDIS analytics experience required.

#3. Minimum 5 years of work experience in healthcare and/or managed care.

#4. SQL experience required.

#5. No more than 3 jobs in the past 10 years

Responsibilities Of The Senior HEDIS Analyst

Responsible for the support, maintenance, and developmental strategies for HEDIS throughout the Company. 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 vendors as needed to ensure that the medical charts meet the standards as outlined by HEDIS specifications (understanding provider chase logic). 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. Position interacts with associates at all levels in the organization, external clients and vendors.

• Experience and ability to utilize a certified HEDIS software
• Experience reviewing medical records is a plus
• Assists as necessary in the HEDIS Road Map and all other documents required by auditors.
• Represent HEDIS team in collaboration with internal departments for HEDIS improvement.
• Manage the HEDIS lifecycle process for multiple plans.
• Develop and maintain HEDIS based report to support Quality Initiatives.
• 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.
• Able to assimilate into team within minimum amount of assistance
• In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs.
• Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.
• Assist in preparation for the HEDIS audit.
• Assist as necessary in the review of medical records.
• Assures the ongoing high-performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers

Requirements Of The Senior HEDIS Analyst

• Bachelor's Degree required with a concentration in health care related field; Master's Degree preferred.
• Minimum 5 years of work experience in healthcare and/or managed care.
• Experience utilizing a certified HEDIS software
• Minimum 2 years HEDIS experience required, 4 years preferred.
• SQL experience required. Tableau / Power BI experience preferred
• Client has a COVID vaccination mandate.

Other Key Requirements

• No sponsorships or visa holders. No Corp-to-Corp.
• 100% Remote

Benefits Of The Senior HEDIS Analyst

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

#remote

About Relevante, Inc. the Recruiting Firm Representing the Client for this Job

Relevante is an accounting & technology direct hire recruiting and contract staffing firm. We help our Clients identify and recruit the best talent in the market and help our candidates win engaging and enriching jobs. Our Clients are some of the best companies to work for among F1000 and emerging fast growth companies in the region. Relevante has been consistently ranked as a fast growth company and one of the largest recruiting, accounting, and management consulting firms in the Philadelphia region. To stay connected with our network, please follow us on LinkedIn https://www.linkedin.com/company/relevante.