DHS
HEDIS Coordinator
Corpus Christi, TX
Sponsorship not specifiedDetected 8 days ago
Data AnalysisProject ManagementExcelMicrosoft Office
About the role
- Where compassion meets innovation and technology and our employees are family.
- Thank you for your interest in joining our team!
- Please review the job information below.
Responsibilities
- Maintains the utmost level of confidentiality at all times.
- Applies analytics from the Provider Performance Platform and other internal sources to identify/target specific populations/providers to maximize quality interventions to optimize administratively captured performance data.
- Coordinates with the Data Analytics and Data Integration teams to gather and validate data needed for modeling and analysis to support departmental and organizational quality strategies and needs.
- Maintains knowledge of industry trends and standards including but not limited to National Committee for Quality Assurance (NCQA) and HEDIS® Technical specifications.
- Performs other duties as requested
- The HEDIS Coordinator develops and implements business and technical processes to acquire, validate, and maintain meaningful external provider data, assess and implement existing DHP vendor data opportunities, and liaise with all stakeholders to identify, optimize, and integrate HEDIS® and other performance data sources to improve Quality data reporting.
- Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.
- Partners with internal stakeholders to ensure that DHP is compliant with regulatory, accreditation, and contractual requirements for HEDIS® Audit and other quality activities to maximize administrative data capture and leverage efficiencies to minimize provider administrative burden.
- Collaborates with internal and external stakeholders to disseminate initiatives andaudit results, including providers/practice groups, and committees.
- This position reports to the Manager of Performance Metrics and works with internal and external stakeholders to develop, implement, monitor, and report quality initiatives
Requirements
- Demonstrates a high degree of independence, flexibility, initiative, and commitment.
- To perform this job successfully, an individual must be able to perform each essential duty satisfactorily.
- The requirements listed below are representative of the knowledge, skill, and/or ability required.
Nice to have
- Knowledge of National Committee on Quality Assurance (NCQA) specifications for HEDIS® audits, the managed care environment, and the basic tenets of quality improvement are strongly preferred.
- clinical data, Electronic Clinical Data Systems (ECDS) reporting methodology, and experience with validating HEDIS® data sources preferred.
Compensation
- This includes coordination with internal and external stakeholders, preparedness for annual HEDIS® reporting, including HEDIS® Electronic Clinical Data Systems (ECDS) measures, and providing ongoing support to sustain the optimal results of the project.
Benefits
- Bachelor's degree in health administration, Business Administration, Information Systems, Health Care, or health-related field required.
- Master's degree in a health-related field preferred.
- Experience with Medicaid or Medicare benefit programs preferred
- Adheres to Health System and Health Plan policies and procedures.
This listing is sourced directly from DHS's careers page and normalized into a canonical job model.