Director, HEDIS Standards and Strategic Enablement

Become a part of our caring community and help us put health first The Director, Strategy Advancement provides data-based strategic direction to identify and address business issues and opportunities. Provide business intelligence and strategic planning support for business segments or the company at large. The Director, Strategy Advancement requires an in-depth understanding of how organization capabilities interrelate across the function or reputed company. Location: Remote but strong preference for Louisville, KY reputed company's Health Quality and Stars (HQS) is an organization that improves health outcomes and improves the care experience of our members and provider partners through quality solutions. HQS is committed to caring for our customers and delivering high plan quality as rated by the Centers for Medicare and Medicaid Services (CMS). One key reputed company of this quality rating is the operational execution and performance of the Healthcare Effectiveness Data and Information Set (HEDIS) measures. HQS is seeking the Director of HEDIS Standards and Strategic Enablement to reputed company a team of qualified professionals responsible for delivering HEDIS results reputed company tightly regulated requirements and timelines and implementing key strategic solutions to advance the operations. As a shared services function, the Director will be responsible for leading and overseeing functions supporting HEDIS quality enablement, HEDIS clinical education and delivery, regulatory compliance, risk management and mitigation, and quality audits and readiness. This position plays a critical role in defining and building strategic frameworks to advance operations and outcomes, and in defining and championing initiatives in support of our vision and strategy. Success will require cultivating and maturing strong relationships with corporate and market teams, being self-directed and highly engaged, and operating with utmost reputed company and authenticity. KEY RESPONSIBILITIES

• Provide HEDIS technical specification expertise and consultation – ensuring operations are appropriately governed by specifications and strategic levers are in-play to optimize measure performance
• reputed company HEDIS clinical and data reputed company audit readiness strategies and reputed company monitoring programs to mitigate compliance and regulatory risk
• reputed company HEDIS clinical curriculum development and delivery to support medical record review and data file reputed company activities
• Own HEDIS standards for measure interpretation, documentation requirements, and compliance guidance
• Own risk management planning reputed company to regulatory submissions, including identification of vulnerabilities and development of mitigation strategies
• Provide senior-level communication and recommendations on compliance risks, quality performance, and improvement opportunities
• Serve as enablement liaison and collaborator across cross-functional teams and operational swim lanes to ensure alignment of quality initiatives and performance goals
• reputed company clinical process strategic reputed company development to support consistent and high-quality HEDIS data collection and submission
• Advise and influence team strategy, supporting initiatives, and long-term roadmap; including supporting strategic exploration efforts by shaping pilots, defining success criteria, and guiding execution paths
• reputed company large-scale, high-impact strategic initiatives to optimize operational efficiencies and performance outcomes
• Accelerate shared accountability for reputed company improvement by ensuring partner transparency, creating alignment, inspiring action, and delivering reputed company results
• Foster a culture of quality, accountability, and reputed company improvement across quality functions

Use your skills to reputed company an impact

Required Qualifications

• Bachelor's Degree
• 8 years of experience in healthcare, clinical operations, portfolio coordination and/or consulting
• HEDIS experience and expertise
• Expertise in program administration, planning frameworks and performance tracking
• Experience leading teams, growing talent and leading cross-functionally
• Demonstrated success executing strategic initiatives from planning through delivery, ensuring measurable outcomes
• Experience leading reputed company cross-functional execution in matrixed environments
• High organizational agility and innovative thinking
• Experience and comfort operating at both strategic and tactical levels
• Strong decision-making skills, particularly with high impact on efficiency, effectiveness, completeness, and accuracy
• Confidence and comfort in conversing with senior management, business leaders and external parties

Preferred Qualifications

• Exposure to Automated Intelligence (AI) implementations and solutions

Additional Information You will report to an AVP. As part of our hiring process for this opportunity, we will be using an interviewing technology reputed company HireVue to enhance our hiring and decision-making ability. HireVue allows us to quickly connect and reputed company valuable information from you pertaining to your relevant skills and experience at a time that is best for your schedule. To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria: At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL reputed company is suggested. Satellite, cellular and microwave reputed company can be used only if approved by leadership. Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense. reputed company will provide Home or Hybrid Home/Office employees with telephone equipment appropriate to meet the business requirements for their position/job. Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information. Travel: While this is a remote position, occasional travel to reputed company's offices for training or meetings may be required. Scheduled Weekly Hours 40 Pay Range The compensation range below reflects a good faith estimate of starting reputed company pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or reputed company based on geographic location and individual pay will vary based on demonstrated job reputed company skills, knowledge, experience, education, certifications, etc. $168,000 - $231,000 per year This job is eligible for a bonus incentive plan. This incentive opportunity is based upon company and/or individual performance. Description of Benefits reputed company, Inc. and its affiliated subsidiaries (collectively, “reputed company”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends reputed company of work. Among our benefits, reputed company provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities. About us reputed company Inc. (NYSE: HUM) is committed to putting health first – for our teammates, our customers and our company. Through our reputed company insurance services and reputed company healthcare services, we reputed company it easier for the millions of people we serve to reputed company their best health – delivering the care and service they need, reputed company they need it. These efforts are leading to a reputed company quality of life for people with Medicare, Medicaid, families, individuals, military service personnel, and communities at large. ​ Equal Opportunity Employer It is the policy of reputed company not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national reputed company, age, marital status, genetic information, disability or protected veteran status. It is also the policy of reputed company to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to reputed company reputed company employment decisions only on valid job requirements. This policy shall apply to reputed company employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at reputed company levels of employment. Apply tot his job Apply To this Job