QI Compliance & Accreditation, Professional, HEDIS Program Manager
Status: Full-time, Exempt: Yes
This position may be a virtual position (worked remotely).
This position will be part of the team that oversees and coordinates Quality functions related to end to end operations of Healthcare Effectiveness Data and Information Set (HEDIS), including medical record collection, abstraction, quality control, analysis, and reporting to meet all requirements of National Committee for Quality Assurance (NCQA) and regulatory agencies. Applies both subject matter and technical expertise to support HEDIS strategies and goals to achieve high performance. Performs responsibilities related to HEDIS supplemental data process, assuring that that the process is timely and contributes to high performance goals related to the gaps in care process. Analyzes HEDIS and other quality data results and identifies performance improvement opportunities. Other duties as assigned.
Bachelor’s degree strongly preferred. Nursing degree or other allied health professional license strongly preferred. Other advanced health-related/business degree or directly related health plan quality experience may be considered combined with education.
Master’s Degree preferred
3 years of experience in clinical quality required
Experience in HEDIS/QARR/STARS in a managed care environment including extensive HEDIS chart review experience required
Experience working with claims and/or other medical management focused systems preferred
Excellent oral and written communication skills including the ability to interact professionally with all levels of the organization
Strong analytical, reporting and problem-solving skills
Strong organization skills and prioritizing ability
Ability to work independently, highly motivated
Demonstrated proficiency in Microsoft Office Suite
MVP Health Care is an Affirmative Action/Equal Opportunity Employer (PDF). We recruit, employ, train, compensate, and promote without regard to race, religion, creed, color, national origin, age, gender, sexual orientation, marital status, disability, genetic information, veteran status, or any other basis, e.g., Pay Transparency (PDF), protected by applicable federal, state or local law. Any person with a disability needing special accommodations to the application process, please contact Human Resources at email@example.com.
- Job Family Medical Management/Clinical
- Pay Type Salary
- 220 Alexander St, Rochester, NY 14607, USA
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