HEDIS Clinical Manager

<strong>Working at Advantasure is more than a job &mdash; you&rsquo;re part of a team that is becoming the country&rsquo;s leading healthcare solutions provider.<br /></strong><br /><strong>A career at Advantasure means you&rsquo;ll be part of one of the most dynamic, diversified and innovative healthcare companies in the nation. You&rsquo;ll be helping our clients make their members healthier &mdash; and our communities a better place to call home.</strong>

Southfield, USA

Advantasure

<p class="p1"><strong>At Advantasure, we partner with healthcare clients to simplify their operations and accelerate their business success. Powered by our broad expertise and a comprehensive suite of product and service solutions, we help health plans effectively navigate the complexity of healthcare.</strong></p> https://advantasure.com/

keywords: job summary,work environment,leadership,solutions,direction exercised,education,experience,knowledge,skills

Non-Manager

Competitive Compensation and Benefits Package

Overview: <br />The role is responsible for planning, organizing, directing, implementing, and leading HEDIS department assignments. This position operates within broad objectives to ensure optimum utilization of manpower and budget. This role researches, compiles, and analyzes appropriate and relevant clinical quality data to identify opportunities to recommend and drive execution<strong>&nbsp;</strong>of process efficiencies in assigned business units to achieve targeted levels of improvement in key operational HEDIS performance metrics.&nbsp;<br /><br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting with no unusual hazards. Travel may be required. This position can be remote across the U.S.</p>
Responsibilities: <br /> <ul> <li>Serve as HEDIS clinical subject matter expert in supporting measure improvement initiative design, annual audit, and MRR project across multiple clients.</li> <li>Responsible for leading clinical HEDIS communications with internal and external parties demonstrating expertise in technical specifications and application in clinical settings.</li> <li>Executes function/area objectives that support continuous improvement.</li> <li>Responsible for special projects and/or problem resolutions.</li> <li>Provides effective and efficient solutions to complex business problems.</li> <li>Provides high-level oversight and leadership.</li> </ul> <br /> <p><strong>DIRECTION EXERCISED:</strong></p> <ul> <li>Directly supervises exempt and non-exempt staff in accordance with company policies and applicable Federal and State Laws.&nbsp;</li> <li>Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION:</strong></p> <ul> <li>Bachelor&rsquo;s degree in a related field.&nbsp;</li> <li>Master&rsquo;s degree in a related field preferred.&nbsp;</li> <li>Relevant combination of education and experience may be considered in lieu of degree.&nbsp;</li> <li>Continuous learning, as defined by the Company&rsquo;s learning philosophy, is required.&nbsp;</li> <li>Certification or progress toward certification is highly preferred and encouraged.</li> </ul> <br /> <p><strong>EXPERIENCE:</strong></p> <ul> <li>Seven (7) years experience of progressive responsibility in a related environment with demonstrated technical knowledge that provides the necessary knowledge, skills, and abilities required.&nbsp;</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Strong knowledge of HEDIS technical specifications. NCQA audit requirements, MRR project oversight, and clinical application of HEDIS quality measures</li> <li>Ability to work under general direction.</li> <li>Ability to work effectively in a team environment.</li> <li>Excellent analytical, organizational, planning, verbal, and written communication skills.</li> <li>Other related skills and/or abilities may be required to perform this job.</li> <li>Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of the organization.</li> <li>Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.</li> <li>Must demonstrate leadership ability and team-building skills to effectively supervise professional and non-professional staff and interact with all levels of management.</li> <li>Ability to work with and empower others on a collaborative basis to ensure success of unit team.</li> <li>Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.</li> <li>Ability to effectively present budgetary and/or cost information, and respond to questions as appropriate.</li> <li>Ability to establish workflows, manage multiple projects, and meet necessary deadlines.</li> </ul>