HEDIS Quality Manager
2.
8 Quick Apply Full-time 17 hours ago Full Job Description POSITION
Summary:
The HEDIS Quality Manager is responsible for coordinating and implementing the STAR's data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5-STAR rating.
This role assists with data analysis and report preparation for all required data submissions.
The HEDIS Quality Manager provides direction and support to the HEDIS coordinator in their market in the implementation of strategies for closing care gaps.
This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the HEDIS/Quality programs.
RESPONSIBILITES:
Provides leadership and support in establishing the Quality Performance Initiatives at the market level, working with clinical offices in capturing the data to support the variables Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data Participates in NCQA HEDIS or Health Plan audits Works with external vendors on data transmission issues Analyzes data for possible data integrity and data deficits Monitors individual and team results to ensure work is completed in a timely manner, in accordance with department standards and procedures, and is in compliance with medical policy and medical necessity guidelines Assigns and prioritizes work, sets goals, and coordinates daily activities of the team Attends and participates in all payor quality meetings Performs all other related duties as assigned
Qualifications:
High School Diploma or GED is required 2
years of healthcare experience (including experience in a managed care setting) HEDIS/STAR experience Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS Ability to use Microsoft Office, with a focus on Excel (or Libre Calc) Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines Excellent training and presentation skills with solid communication capabilities and practices, both oral and written Ability to read, understand, and analyze medical records Ability to be flexible in a continuously changing environment Ability to collect and accurately relay pertinent information Ability to read and understand technical specifications on all quality initiatives Ability to multitask and prioritize assignments based on urgency Ability to work independently with little to no need for assistance Job Type:
Full-time Pay:
From $50,000.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday Application Question(s):
How many years of healthcare experience do you have (specifically in the Managed Care setting)?
Experience:
HEDIS:
4 years (Preferred) Work Location:
One location Provides leadership and support in establishing the Quality Performance Initiatives at the market level, working with clinical offices in capturing the data to support the variables Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data Participates in NCQA HEDIS or Health Plan audits Works with external vendors on data transmission issues Analyzes data for possible data integrity and data deficits Monitors individual and team results to ensure work is completed in a timely manner, in accordance with department standards and procedures, and is in compliance with medical policy and medical necessity guidelines Assigns and prioritizes work, sets goals, and coordinates daily activities of the team Attends and participates in all payor quality meetings Performs all other related duties as assigned High School Diploma or GED is required 2
years of healthcare experience (including experience in a managed care setting) HEDIS/STAR experience Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS Ability to use Microsoft Office, with a focus on Excel (or Libre Calc) Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines Excellent training and presentation skills with solid communication capabilities and practices, both oral and written Ability to read, understand, and analyze medical records Ability to be flexible in a continuously changing environment Ability to collect and accurately relay pertinent information Ability to read and understand technical specifications on all quality initiatives Ability to multitask and prioritize assignments based on urgency Ability to work independently with little to no need for assistance 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance 8 hour shift Monday to Friday How many years of healthcare experience do you have (specifically in the Managed Care setting)? HEDIS:
4 years (Preferred) Quick Apply.
Estimated Salary: $20 to $28 per hour based on qualifications.
8 Quick Apply Full-time 17 hours ago Full Job Description POSITION
Summary:
The HEDIS Quality Manager is responsible for coordinating and implementing the STAR's data collection and works in collaboration with the Director of Quality to develop strategies for achieving a 5-STAR rating.
This role assists with data analysis and report preparation for all required data submissions.
The HEDIS Quality Manager provides direction and support to the HEDIS coordinator in their market in the implementation of strategies for closing care gaps.
This role works closely and collaboratively with various functional areas of the delivery system to achieve the goals and objectives of the HEDIS/Quality programs.
RESPONSIBILITES:
Provides leadership and support in establishing the Quality Performance Initiatives at the market level, working with clinical offices in capturing the data to support the variables Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data Participates in NCQA HEDIS or Health Plan audits Works with external vendors on data transmission issues Analyzes data for possible data integrity and data deficits Monitors individual and team results to ensure work is completed in a timely manner, in accordance with department standards and procedures, and is in compliance with medical policy and medical necessity guidelines Assigns and prioritizes work, sets goals, and coordinates daily activities of the team Attends and participates in all payor quality meetings Performs all other related duties as assigned
Qualifications:
High School Diploma or GED is required 2
years of healthcare experience (including experience in a managed care setting) HEDIS/STAR experience Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS Ability to use Microsoft Office, with a focus on Excel (or Libre Calc) Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines Excellent training and presentation skills with solid communication capabilities and practices, both oral and written Ability to read, understand, and analyze medical records Ability to be flexible in a continuously changing environment Ability to collect and accurately relay pertinent information Ability to read and understand technical specifications on all quality initiatives Ability to multitask and prioritize assignments based on urgency Ability to work independently with little to no need for assistance Job Type:
Full-time Pay:
From $50,000.
00 per year
Benefits:
401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance Schedule:
8 hour shift Monday to Friday Application Question(s):
How many years of healthcare experience do you have (specifically in the Managed Care setting)?
Experience:
HEDIS:
4 years (Preferred) Work Location:
One location Provides leadership and support in establishing the Quality Performance Initiatives at the market level, working with clinical offices in capturing the data to support the variables Provides expertise to the training department on STAR/HEDIS measures and on the tools that support the collection of STAR/HEDIS data Participates in NCQA HEDIS or Health Plan audits Works with external vendors on data transmission issues Analyzes data for possible data integrity and data deficits Monitors individual and team results to ensure work is completed in a timely manner, in accordance with department standards and procedures, and is in compliance with medical policy and medical necessity guidelines Assigns and prioritizes work, sets goals, and coordinates daily activities of the team Attends and participates in all payor quality meetings Performs all other related duties as assigned High School Diploma or GED is required 2
years of healthcare experience (including experience in a managed care setting) HEDIS/STAR experience Basic understanding of quality improvement standards such as NCQA, HEDIS, CAHPS, HOS and CMS Ability to use Microsoft Office, with a focus on Excel (or Libre Calc) Demonstrated competency in setting priorities for a team and overseeing work outputs and timelines Excellent training and presentation skills with solid communication capabilities and practices, both oral and written Ability to read, understand, and analyze medical records Ability to be flexible in a continuously changing environment Ability to collect and accurately relay pertinent information Ability to read and understand technical specifications on all quality initiatives Ability to multitask and prioritize assignments based on urgency Ability to work independently with little to no need for assistance 401(k) 401(k) matching Dental insurance Health insurance Life insurance Paid time off Vision insurance 8 hour shift Monday to Friday How many years of healthcare experience do you have (specifically in the Managed Care setting)? HEDIS:
4 years (Preferred) Quick Apply.
Estimated Salary: $20 to $28 per hour based on qualifications.
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