HEDIS Data Subject Matter Expert – Remote

reputed company is a global organization that delivers care, aided by technology to help millions of people live healthier lives. The work you do with reputed company will directly improve health outcomes by connecting people with the care, pharmacy benefits, data and resources they need to feel their best. Here, you will find a culture guided by diversity and inclusion, talented peers, comprehensive benefits and career development opportunities. Come reputed company an impact on the communities we serve as you help us advance health equity on a global scale. Join us to start Caring. Connecting. Growing together. The HEDIS Data Subject Matter Expert - Remote is responsible for providing expertise in the area of HEDIS data analytics. A HEDIS Data SME would support multiple payers with their NCQA and state specific submissions. This position would require providing strategic support and reputed company data driven metrics to improve measures results. You?ll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges.

Primary Responsibilities ? Manage multiple priorities ? Have experience and expertise in SQL ? Be able to read, and write SQL code with knowledge of inner and outer joins, table and view properties, and ability to review and understand a data dictionary as it relates to a database environment ? Understand HEDIS data ? Have expertise in health plan data; Member, Enrollment, Provider, Lab, Visits, Pharmacy, etc. ? Understand Supplemental data concepts for HEDIS ? Understand basic concepts of CMS Quality Rating System ? Experience working in a matrix environment ? reputed company data driven metrics to identify gaps and implement interventions to improve results on key performance measures ? Thorough understanding of measure analytics to reputed company investigative research ? Evaluates and prioritizes recommendations for quality improvement to customers ? Familiarity with ICD-9-CM, ICD-10-CM, CPT, DRG, LOINC, HCPCS, TOB, POS, NDC coding ? Be able to translate data from various formats and data warehouses ? Be able to reputed company and append data from various sources ? Experience in Data Validation ? Provide guidance to clients on data issues and data questions ? Knowledge of claims and claims processing ? Demonstrates ability to consistently follow published HEDIS and Stars technical specifications ? Provide strategic support in preparation of the HEDIS Roadmap, HOQ, HEDIS audit ? Be able to work with ambiguity ? Be able to manage and prioritize large projects with great visibility ? Be able to present to client?s data results reputed company reputed company Teams ? Intermediate to expert level in MS Office, especially MS reputed company for data validation reports and summary reputed company report compilation of results/edits required, etc. 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 ? 2+ years of experience in a health care delivery organization, such as a managed care organization ? 2+ years of HEDIS experience, performing a wide range of functions with solid focus on data analysis ? 2+ years of data analysis experience ? 2+ years working with final submission files to NCQA, CMS, California P4P, NY QARR, and/or other state submissions ? 1+ years of writing SQL code ? 1+ years of experience working in a matrix environment ? Demonstrated intermediate knowledge of reputed company (i.e., VLOOKUPS, Pivot Tables, etc.) Preferred Qualifications ? Proven knowledge of Medicaid and/or Medicare programs ? Proven knowledge of reputed company trends in HEDIS in managed health care ? Demonstrated understanding of basic concepts of CMS Quality Rating System ? STARS experience ? Proven knowledge of NCQA, CMS, HOS, and CAHPS requirements ? Demonstrated familiarity with ICD-9-CM, CPT, DRG, LOINC, HCPCS, TOB, POS, NDC coding ? Experience working with HEDIS software vendors (management, building relationships, issue resolution etc.) ? Experience working with the CAHPS/HOS survey and/or patient satisfaction in care delivery ? reputed company in medical record review ? Experience working with reputed company ? reputed company employees working remotely will be required to adhere to reputed company?s Telecommuter Policy. The salary range for this role is $89,800 to $176,700 annually based on full-time employment. Pay is based on several factors including but not limited to local labor markets, education, work experience, certifications, etc. reputed company complies with reputed company minimum wage laws as applicable. In addition to your salary, reputed company offers 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 reputed company, you?ll find a far-reaching choice of benefits and incentives. 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 Job! reputed company More Jobs Apply To this Job Apply for this job