HEDIS Coordinator

<strong>At Emergent Holdings, we&rsquo;re creating an innovative environment where our employees belong authentically, contribute meaningfully, and thrive intentionally &mdash; both personally and professionally.</strong>

United States, USA

Emergent Holdings

<h3><strong>Attention:</strong></h3> <p><strong>From Dec. 7, 2020 until Dec. 27, 2020, we will be undergoing a transition to a new recruitment technology platform. During that time, we will not be able to accept applications.</strong></p> <p><strong>We apologize for any inconvenience this may cause.</strong></p> <p><strong>We appreciate your interest in joining our team, and would love for you to come back on Dec. 27 to apply.</strong></p> <p><strong>Thank you!</strong></p> https://emergentholdingsinc.com/

keywords: summary,work environment,coordinate,data,projects,compliance,relations,education & experience,knowledge,skills,other abilities

Non-Manager

Competitive Compensation and Benefits Package

Overview: <br />The Quality Senior Analyst is an analytical role responsible for HEDIS Operations project support and coordination of the development and implementation of programs and strategies to improve service to our customers.<br /><br /> <p><strong>WORKING CONDITIONS:</strong></p> <p>Work is performed in an office setting with no unusual hazards.&nbsp;</p>
Responsibilities: <br /> <ul> <li>Coordinates client HEDIS audit management requirements (Roadmap, monitoring HEDIS timelines, audit review, medical record review validation, etc).</li> <li>Coordinates medical record review projects including provider data cleaning, chase management, monitor quality, and rate performance, and post HEDIS analytics. Develops and improves workflows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.</li> <li>Identifies and/or analyzes business problems and devise procedures for solutions to the problems.</li> <li>Effectively leads projects in order to produce desired results.</li> <li>Responsible for corporate communication of project results.</li> <li>Recommends and assists with implementing standard policies and procedures.</li> <li>Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.</li> <li>Participates in systems testing, develops procedures/controls and provides recommendations for the ongoing improvement of the updated process.</li> <li>Assists personnel (both internal and external) by answering questions, supplying information, and training.</li> <li>Develops and maintains an effective working relationship with customers.</li> <li>Participates in group or committee discussions.</li> <li>Develops documentation, reports, and presentations for all levels within the organization including executive leadership.</li> <li>Collaborates with Subject Matter Experts to develop accurate documents.</li> <li>Completes ad hoc data requests as assigned. Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.</li> <li>Coordinates projects and analysis for management and team.</li> <li>Ensures complete, accurate, and timely data for reporting purposes.</li> <li>Researches, analyzes, identifies, and evaluates data from assigned problems to evaluate existing and potential trends and issues.</li> </ul>
Requirements: <br /> <p><strong>EDUCATION:</strong></p> <ul> <li>Bachelor&rsquo;s degree in a related field.&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>Two (2) to four (4) years experience in related field. &nbsp;</li> <li>Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.</li> </ul> <br /> <p><strong>SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:</strong></p> <ul> <li>Knowledge of HEDIS specifications and process.</li> <li>Analytical, organizational, planning, and problem-solving skills</li> <li>Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies</li> <li>Ability to plan, organize, direct, and control projects.</li> <li>Excellent written and verbal communication skills.</li> <li>Ability to lead and contribute to process improvement projects.</li> <li>Ability to read and interpret documents such as data flows, process flows, technical diagrams, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of 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>Administer and adhere to corporate and departmental policies, practices, and procedures.</li> <li>Knowledge of healthcare information technology and HEDIS medical record review process</li> <li>Strong knowledge and use of Microsoft PowerPoint and Word</li> <li>Advanced Microsoft Excel skills &ndash; pivot tables, complex formulas, macros, etc.</li> <li>Strong analytical, organizational, planning, and problem-solving skills.</li> </ul>