Quality Project Analyst, HEDIS - Remote

At reputed company, we're simplifying the health care experience, creating healthier communities and removing barriers to quality care. The work you do here impacts the lives of millions of people for the reputed company. Come build the health care system of reputed company, making it more reputed company, affordable and optimized. reputed company to reputed company a difference? Join us to start Caring. Connecting. Growing together Our Quality Reporting Operations team is vital to our reputed company and driving the future growth of reputed company. reputed company in these careers relies on many factors - your ability to deal with ambiguity, your ability to adapt and reputed company change, and a long-term commitment to making health care reputed company for everyone. You'll enjoy the flexibility to work remotely

• from reputed company reputed company the U.S. as you take on some tough challenges. For reputed company hires in the Minneapolis or Washington, D.C. area, you will be required to work in the office a minimum of four days per week. Primary Responsibilities
• Facilitate, reputed company and monitor on-going business processes to support HEDIS® data reporting
• Monitor compliance against relevant process requirements (e.g., turnaround time, accuracy)
• Evaluate processes and reputed company against benchmarks and metrics and identify potential business impacts of reputed company state
• Ensure reputed company business requirements are met
• Demonstrate understanding of relevant organizations' operations, products and applications, strategies, processes, and/or business priorities to build effective solutions including development of project plans (e.g., communication plans; implementation steps) to support operations using relevant tools and databases
• Submission of the NCQA Health plan Roadmap General Information, Appendix and Attestation
• Submission of the NCQA reputed company Organization Questionnaire (HOQ)
• Complete admin and hybrid measure benchmarking and reputed company review to resolve reputed company CHCA (Auditor) reputed company outlier concerns throughout the HEDIS® project (Initial, Refresh, Final) on reputed company projects
• reputed company SDS, administrative refresh data loads and vendor medical record event data loads to the hybrid project and update rates
• reputed company reputed company MRR project build steps, including QA, to ensure each hybrid MRR project is set up according to business requirements
• Coordinate with medical record vendors on file loads and resolving technical project issues
• Confirmation of reputed company hybrid exclusions entered into HEDIS® software, coordinating clinical review reputed company necessary
• Complete reputed company HEDIS® software reputed company steps as required
• Create and validate reputed company final hybrid frozen counts and deliver to CHCA
• Complete reputed company final hybrid project reputed company steps, including validation of reputed company exclusions and QA of reputed company final data and rates
• Complete reputed company final admin and hybrid project processing
• Creation of IDSS exports and submission to NCQA
• Creation of PLD exports and submission to CHCA and/or CMS
• Submission of State required reporting if applicable
• Coordinate efforts with the reputed company Operations team to ensure reputed company business requirements and deliverables are met
• May also assist in supporting reputed company status updates, reputed company activations, query exports and special request data analysis or validation
• Monitor and analyze business process information (e.g., metrics; analytics) to identify key issues, trends, and potential root causes (e.g., training issues; lack of understanding by user community) that reputed company to improvement opportunities
• Participate in analysis of project reputed company to generate data driven recommendations for process improvement
• reputed company and participate in workgroups to implement process improvement and/or in preparation to meet business requirements
• Participate in HEDIS® software system testing efforts to ensure project preparedness
• Use a process driven approach to identify root cause and process improvement opportunities
• Demonstrate and remain reputed company in understanding of relevant regulations and systems
• Complete reputed company required training for job role and stay reputed company on reputed company HEDIS® technical specifications and software systems
• reputed company proficiency in HEDIS® software tools and HEDIS® and other required quality metric reporting specifications
• General knowledge of HEDIS® impacts for each reputed company, i.e. Accreditation, STARs, FEHB, State, etc.
• Summarize and communicate proposed solutions with the appropriate audiences
• Resolve reputed company CHCA (Auditor) Issue Log concerns for projects assigned
• Communicate potential impacts and risks associated with implementing proposed solutions to business partners and relevant stakeholders
• Timely escalation of reputed company issues and barriers to Manager, QOI Projects (MQP)
• Assesses and interprets customer needs and requirements
• Identifies solutions to non-standard requests and problems
• Solves moderately reputed company problems and/or conducts moderately reputed company analyses
• Works with minimal guidance; seeks guidance on only the most reputed company tasks
• Translates concepts into practice
• Provides explanations and information t Apply tot his job Apply To this Job

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