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HEDIS Expert Analyst at Emergent Holdings

Posted in Other 30+ days ago.

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Location: Richmond, Virginia





Job Description:
SUMMARY:

The HEDIS Expert Analyst is responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions. This role also coordinates projects for senior management.

RESPONSIBILITIES/TASKS:
  • Develops documentation, reports and presentations for all levels within the organization including executive leadership.
  • Collaborates with Subject Matter Experts to develop accurate documents.
  • Completes ad hoc data requests as assigned. Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.
  • Coordinates projects and analysis for management and team.
  • Ensures complete, accurate and timely data for reporting purposes.
  • Researches, analyzes, identifies, and evaluates data from assigned problems to evaluate existing and potential trends and issues.
  • Researches, analyzes, identifies, and evaluates data from assigned problems to evaluate existing and potential trends and issues.
  • Possesses and maintains a comprehensive understanding and knowledge of business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and research principles/methodologies.
  • Assists in the management and monitoring of multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.
  • Communicates results of analysis to management via reports/presentations and assist management in implementing programs that provide solutions.
  • Recommends and implements solutions to identified problems/root cause of issues.
  • Provides expertise and guidance to unit and corporate staff as required.
  • Represents and participates in group or committee discussions.
  • Assists and support HEDIS Compliance Audit requirements (Roadmap, onsite visit, medical record review validation, supplemental data validation, etc.).
  • Assists and support medical record projects including provider data cleaning, chase management, quality performance and post HEDIS analytics.


This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.
EMPLOYMENT QUALIFICATIONS:

EDUCATION:

Bachelor's degree in Business Administration, Economics, Health Care, Information Systems, Statistics or a related field. Master's degree preferred. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.

EXPERIENCE:

Five (5) years of experience in HEDIS is required to provide the necessary knowledge, skills, and abilities for the role.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
  • Knowledge of HEDIS guidelines and requirements.
  • Strong communication skills are required to understand, interpret, and communicate ideas.
  • Strong knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
  • Strong analytical, organizational, planning, and problem-solving skills.
  • Ability to effectively interface with employees at all levels.
  • Understand and apply statistical inference.
  • Other related skills and/or abilities may be required to perform this job.
  • Experience executing in a fast-paced environment with tight deadlines.
  • Administer and adhere to corporate and departmental policies, practices and procedures.


WORKING CONDITIONS:

Work is performed in an office setting with no unusual hazards.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.

We are an Equal Opportunity Employer. Diversity is valued and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an "at will" basis. Nothing herein is intended to create a contract.