[Hiring] HEDIS Analyst @Amerihealth Caritas

Role Description

The HEDIS Analyst supports corporate, plan-level, and departmental strategies for the HEDIS process by managing the full lifecycle of HEDIS measures, ensuring data accuracy, and interpreting results into actionable recommendations. This role requires a combination of technical skills, like using HEDIS software and SQL, and business knowledge to support initiatives and solve problems related to healthcare quality metrics. The HEDIS Analyst collaborates with internal departments and external vendors to manage projects, prepare for audits, and produce reports to improve quality ratings.

Work Arrangement:

• Remote role.
• Monday through Friday from 8:00a EST to 5:00p EST.

Responsibilities

• Manage the HEDIS lifecycle process for multiple plans.
• Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations.
• In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs.
• Assist in preparation for the HEDIS audit.
• Develop and maintain HEDIS based report to support Quality Initiatives.
• Represent HEDIS team in collaboration with internal departments for HEDIS improvement.
• Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.
• Assists as necessary in the HEDIS Road Map and all other documents required by auditors.
• Able to assimilate into team within minimum amount of assistance.
• Assures the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers.
• Experience and ability to utilize a certified HEDIS software.

Qualifications

• Bachelor’s Degree preferred with a concentration in health care related field.
• Minimum of 1 year HEDIS experience required.
• Minimum of 5 years of work experience in healthcare and/or managed care.
• SQL experience required.

Benefits

• Flexible work solutions including remote options, hybrid work schedules.
• Competitive pay.
• Paid time off including holidays and volunteer events.
• Health insurance coverage for you and your dependents on Day 1.
• 401(k).
• Tuition reimbursement and more.