Manager, HEDIS Operations (Non-Clinical) Job at Pennsylvania Health & Wellness
You could be the one who changes everything for our 26 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.
THIS POSITION IS REMOTE/WORK FROM HOME.
Position Purpose: Oversee and ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement opportunities. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization, maximizing opportunity to improve outcomes for members.
Oversee activities, resources, methods, and procedures to achieve improvement in HEDIS measures
Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines
Provide comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures to senior management
Manage all clinical quality metrics and HEDIS processes and results
Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
Oversee all HEDIS projects to include assignment of nurses, adherence to plan timelines, and vendor oversight for timeliness and quality
Ensure compliance for all quality audits and maintain all data and process controls
Education/Experience: Bachelor's degree in Business Administration, or Health Care Administration or equivalent experience. 4+ years of HEDIS project management or healthcare management experience. Advanced working knowledge of HEDIS technical specifications. Quality improvement experience preferred. Master’s degree preferred.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
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THIS POSITION IS REMOTE/WORK FROM HOME.
Position Purpose: Oversee and ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement opportunities. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization, maximizing opportunity to improve outcomes for members.
Oversee activities, resources, methods, and procedures to achieve improvement in HEDIS measures
Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines
Provide comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures to senior management
Manage all clinical quality metrics and HEDIS processes and results
Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
Oversee all HEDIS projects to include assignment of nurses, adherence to plan timelines, and vendor oversight for timeliness and quality
Ensure compliance for all quality audits and maintain all data and process controls
Education/Experience: Bachelor's degree in Business Administration, or Health Care Administration or equivalent experience. 4+ years of HEDIS project management or healthcare management experience. Advanced working knowledge of HEDIS technical specifications. Quality improvement experience preferred. Master’s degree preferred.
Our Comprehensive Benefits Package: Flexible work solutions including remote options, hybrid work schedules and dress flexibility, Competitive pay, Paid time off including holidays, Health insurance coverage for you and your dependents, 401(k) and stock purchase plans, Tuition reimbursement and best-in-class training and development.
Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.
Please Note :
clarksqn.com is the go-to platform for job seekers looking for the best job postings from around the web. With a focus on quality, the platform guarantees that all job postings are from reliable sources and are up-to-date. It also offers a variety of tools to help users find the perfect job for them, such as searching by location and filtering by industry. Furthermore, clarksqn.com provides helpful resources like resume tips and career advice to give job seekers an edge in their search. With its commitment to quality and user-friendliness, Site.com is the ideal place to find your next job.