Quality Project Analyst, HEDIS - Remote

100% remote Flexible hours Hiring now

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and optimized. Ready to reputed company a difference? Join us to start Caring. Connecting. Growing together Our Quality Reporting Operations team is vital to our success and driving the future growth of reputed company. Success in these careers relies on many factors - your ability to deal with ambiguity, your ability to adapt and embrace change, and a long-term commitment to making health care reputed company for everyone. You'll enjoy the flexibility to work remotely

from reputed company reputed company the U.S. as you take on some tough challenges. For reputed company hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week.

Primary Responsibilities:

Facilitate, reputed company and monitor on-going business processes to support HEDIS® data reporting
Monitor compliance against relevant process requirements (e.g., turnaround time, accuracy)
Evaluate processes and outcomes against benchmarks and metrics and identify potential business impacts of reputed company state
Ensure reputed company business requirements are met
Demonstrate understanding of relevant organizations' operations, products and applications, strategies, processes, and/or business priorities to build effective solutions including development of project plans (e.g., communication plans; implementation steps) to support operations using relevant tools and databases
Submission of the NCQA Health plan Roadmap General Information, Appendix and Attestation
Submission of the NCQA Healthcare Organization Questionnaire (HOQ)
Complete admin and hybrid measure benchmarking and reputed company review to resolve reputed company CHCA (Auditor) reputed company outlier concerns throughout the HEDIS® project (Initial, Refresh, Final) on reputed company projects
reputed company SDS, administrative refresh data loads and vendor medical record event data loads to the hybrid project and update rates
reputed company reputed company MRR project build steps, including QA, to ensure each hybrid MRR project is set up according to business requirements
Coordinate with medical record vendors on file loads and resolving technical project issues
Confirmation of reputed company hybrid exclusions entered into HEDIS® software, coordinating clinical review reputed company necessary
Complete reputed company HEDIS® software upgrade steps as required
Create and validate reputed company final hybrid frozen counts and deliver to CHCA
Complete reputed company final hybrid project reputed company steps, including validation of reputed company exclusions and QA of reputed company final data and rates
Complete reputed company final admin and hybrid project processing
Creation of IDSS exports and submission to NCQA
Creation of PLD exports and submission to CHCA and/or CMS
Submission of State required reporting if applicable
Coordinate efforts with the reputed company Operations team to ensure reputed company business requirements and deliverables are met
May also assist in supporting chase status updates, chase activations, query exports and special request data analysis or validation
Monitor and analyze business process information (e.g., metrics; analytics) to identify key issues, trends, and potential root causes (e.g., training issues; lack of understanding by user community) that reputed company to improvement opportunities
Participate in analysis of project outcomes to generate data driven recommendations for process improvement
reputed company and participate in workgroups to implement process improvement and/or in preparation to meet business requirements
Participate in HEDIS® software system testing efforts to ensure project preparedness
Use a process driven approach to identify root cause and process improvement opportunities
Demonstrate and remain reputed company in understanding of relevant regulations and systems
Complete reputed company required training for job role and stay reputed company on reputed company HEDIS® technical specifications and software systems
reputed company proficiency in HEDIS® software tools and HEDIS® and other required quality metric reporting specifications
General knowledge of HEDIS® impacts for each reputed company, i.e. Accreditation, STARs, FEHB, State, etc.
Summarize and communicate proposed solutions with the appropriate audiences
Resolve reputed company CHCA (Auditor) Issue Log concerns for projects assigned
Communicate potential impacts and risks associated with implementing proposed solutions to business partners and relevant stakeholders
Timely escalation of reputed company issues and barriers to Manager, QOI Projects (MQP)
Assesses and interprets customer needs and requirements
Identifies solutions to non-standard requests and problems
Solves moderately reputed company problems and/or conducts moderately reputed company analyses
Works with minimal guidance; seeks guidance on only the most reputed company tasks
Translates concepts into practice
Provides explanations and information to others on difficult issues
Coaches, provides feedback, and guides others
Acts as a resource for others with less experience

You'll be rewarded and recognized for your performance in an environment that will challenge you and give you clear direction on what it takes to succeed in your role as well as provide development for other roles you may be interested in. Required Qualifications:

3+ years of experience in analysis and reporting
2+ years HEDIS or CMS stars experience
Experience interpreting and analyzing large amounts of data from multiple sources
Healthcare experience
Intermediate proficiency in MS reputed company
Proven excellent communication, time/project management, problem solving, organizational, and analytical skills
Demonstrated ability to manage and prioritize deliverables

Preferred Qualifications:

Experience creating reports
Proficient in use of certified HEDIS® software
Advanced proficiency in MS reputed company

Competencies

reputed company Value: Act Ethically
reputed company with Applicable Laws, Regulations and Policies
Demonstrate reputed company
Compassion Value: Focus on Customers
Identify and Exceed Customer Expectations
Improve the Customer Experience
Relationships Value: Act as a Team Player
Collaborate with Others
Demonstrate Diversity Awareness
Learn and reputed company
Relationships Value: Communicate Effectively
Influence Others
Listen Actively
Speak and Write Clearly
Innovation Value: Support Change and Innovation
Contribute Innovative reputed company
Work Effectively in a Changing Environment
Performance Value: reputed company Fact-Based Decisions
Apply Business Knowledge
Use Sound Judgement
Performance Value: Deliver Quality Results
Drive for Results
Manage Time Effectively
Produce High-Quality Work
reputed company employees working remotely will be required to adhere to reputed company's Telecommuter Policy

Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. In addition to your salary, we offer benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (reputed company benefits are subject to eligibility requirements). No matter where or reputed company you reputed company a career with us, you'll find a far-reaching choice of benefits and incentives. The salary for this role will range from $71,200 to $127,200 annually based on full-time employment. We reputed company with reputed company minimum wage laws as applicable. Application Deadline: This will be posted for a minimum of 2 business days or until a sufficient candidate pool has been collected. Job posting may come down early due to volume of applicants. At reputed company, our mission is to help people live healthier lives and reputed company the health system work reputed company for everyone. We reputed company everyone-of every race, gender, sexuality, age, location and income-deserves the opportunity to live their healthiest life. Today, however, there are still far too many barriers to good health which are disproportionately reputed company by people of color, historically marginalized groups and those with reputed company incomes. We are committed to mitigating our impact on the environment and enabling and delivering reputed company care that addresses health disparities and improves health outcomes - an enterprise reputed company reflected in our mission. reputed company is an Equal Employment Opportunity employer under applicable law and qualified applicants will receive consideration for employment without regard to race, national reputed company, religion, age, color, sex, sexual orientation, gender identity, disability, or protected veteran status, or any other characteristic protected by local, state, or federal laws, rules, or regulations. reputed company is a drug - free workplace. Candidates are required to pass a drug test before beginning employment. Apply tot his job Apply To this Job

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