Quality Analyst (Remote)- HEDIS
Advantasure

Job Info

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SUMMARY:

The Quality Analyst is a role responsible for HEDIS Operations project support. This primarily includes support during the HEDIS and Supplemental Data seasons by performing medical record review abstraction and assisting in audit activities, coordination of the development and implementation of programs and strategies to improve service to our customers.

RESPONSIBILITIES/TASKS:

• Possess and maintains a comprehensive understanding and knowledge of HEDIS Medical Record Review activities - specifically client abstractions, data audit, and HEDIS/Stars technical specifications.
• Assists with ongoing abstraction and overread activities in support of the clients during the HEDIS medical record review and Supplemental data seasons.
• Collaborates with coordinators on HEDIS audit submissions for all clients.
• Effectively support a broad range of HEDIS clients and products.
• Coordinates across teams to collect data for the Quality Program projects to be used for analysis by internal and external teams.
• Develops and maintains an effective working relationship with customers and internal business partners.
• Represents and participates in group or committee discussions.
• Develops documentation, reports, and presentations for all levels within the organization including executive leadership and clients.
• Collaborates with Subject Matter Experts to develop accurate documents.
• Communicates results of analysis to management and clients via reports/presentations and assists management in implementing programs that provide solutions.
• Assists in the management and monitoring of multiple HEDIS projects simultaneously by establishing objectives to ensure goal attainment within defined parameters.
• Communicates results of analysis to management and clients via reports/presentations and assists management in implementing programs that provide solutions.
• Contributes to and leads projects that have been identified to improve efficiency and accuracy. Researches, analyzes, identifies, and evaluates data that supports clients' troubleshooting needs and prospective business decisions. Provides expertise and guidance to staff as required.

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, Mathematics, Statistics, Health Care or a related field is required. Continuous learning, as defined by the Company's learning philosophy, is required.

Certified Analytics Professional (CAP) or Certified Professional in Healthcare Quality (CPHQ) is highly preferred and encouraged.

EXPERIENCE:

One (1) to three (3) years experience in related field. Analyst experience required with proven experience in medical record review abstraction and overreading, operational analysis, data analysis, and problem resolution type activities.

SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:

• Knowledge of the HEDIS medical record review guidelines, requirements, and process.
• Knowledge of products reported for HEDIS.
• Ability to effectively learn and stay up to date on new technical specifications and how it translates to medical record review, reporting, and analysis.
• Self-starter that is comfortable with ambiguity and has ability to identify, implement, and execute on business strategies.
• Execellent analytical, organizational, planning, and problem-solving skills
• Understanding and knowledge of the business, products, programs, corporate organizational structure (including functional responsibilities), and basic research principles/methodologies
• Ability to plan, organize, direct, and troubleshoot issues in support of internal and external projects.
• Strong written and verbal communication skills are required to understand, interpret, and communicate ideas.
• Ability to lead and contribute to process improvement projects.
• Ability to read and interpret documents such as data flows, process flows, and operational reporting.
• Ability to speak effectively before groups of customers or employees of organization.
• Administer and adhere to corporate and departmental policies, practices and procedures.
• Strong knowledge and use of existing software packages (PowerPoint, Excel, Word).
• Experience executing in a fast-paced environment with tight deadlines.

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.

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