HEDIS Analyst

  • Full-time

Job Description

Title: Hedis Analyst.

Location: Philadelphia, PA, 19113.

Duration: 3+ Months (Possible Extension).

Hours: Monday to Friday 08:00 to 05:00 PM EST.

Short 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:

  • 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 a team within 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 a certified HEDIS software.

Additional Information

Experience:

  • 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 a health care related field; Master’s Degree preferred.