Apply Now

QI Compliance & Accreditation, Professional, HEDIS Program Manager

220 Alexander St, Rochester, NY 14607, USA; Headquarters Office, 625 State Street, Schenectady, New York, United States of America; Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America; Virtual Req #581
Friday, July 31, 2020
Be a part of the transformation at MVP Health Care®. MVP Health Care is a nationally-recognized, regional not-for-profit health insurer. We care for more than 700,000 members across New York and Vermont and are powered by the ideas and energy of more than 1,700 employees. We employ talented people  with diverse backgrounds and experience—tech people, numbers people, even people people—to make health insurance more convenient, more supportive, and more personal. If you’re ready to join a thriving, mission-driven company where you can create your own opportunities—it’s time to make a healthy career move to MVP.

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.

Position Qualifications 


Minimum Education

  • 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

Minimum Experience

  • 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

Required Skills

  • 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

  • Team oriented

  • Ability to work independently, highly motivated

  • Demonstrated proficiency in Microsoft Office Suite

#zip

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 hr@mvphealthcare.com.

Other details

  • Job Family Medical Management/Clinical
  • Pay Type Salary
  • 220 Alexander St, Rochester, NY 14607, USA
  • Headquarters Office, 625 State Street, Schenectady, New York, United States of America
  • Tarrytown Office, 303 South Broadway, Tarrytown, New York, United States of America
  • Virtual