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Manager, HEDIS

Maryland Heights, MO
HEDIS Supervisor will be responsible for overseeing the daily operations of the HEDIS/Star analytics team within th Quality Improvement department. Provides guidance for complex analytics and reporting in support of the annual HEDIS submission, Medicare Star program, NCQA accreditation, and regulatory and contractual compliance. Coaches, mentors and leads team to ensure timely and accurate reporting to meet accreditation, regulatory requirements and performance measure targets.
Job Description:
Role and Responsibilities:
  • Serves as a subject matter expert on HEDIS measures and the annual HEDIS process, as well as the Medicare Star program and annual rating process
  • Determines the resources and participants needed to achieve goals.
  • Builds and develops collaborative relationships vital to the success of programs.
  • Delegates tasks and responsibilities to manage dependencies and critical path resulting in program activities completed on time and within budget.
  • May be responsible for concurrent and/or retrospective review, data abstraction, analysis, identification of critical issues, process improvement support, required education, and assisting with measurement of performance metrics.

Experience, Qualifications and Education:
  • Bachelor degree preferred but will accept less in lieu of experience
  • 2-3 Years HEDIS program experience required
  • Knowledge of Quality Management Programs
  • Knowledge of NCQA URAC accreditation and certification
  • 2+ years Medicare Medicaid or commercial health plan experience required
  • Strong written and communication skills with the ability to write clear, structured, articulate, and persuasive proposal responses
  • Strong editing skills with attention to detail and ability to meet deadlines
  • Experience working in deadline-driven environments
  • Able to work well in a team environment, handle multiple tasks, and meet deadlines
  • High level initiative, problem solving, and collaboration abilities
  • Able to effectively coordinate efforts across different organizational departments and also with external organizations
  • Able to monitor and meet program goals
  • Proficient in use of Microsoft Office Suite and use of the Internet

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