HEDIS Program Manager - Steward Health Care Network
Project manage all aspects of collection of hybrid performance measure data and submission of this data to regulatory and accreditation bodies in an accurate, complete and timely fashion. Identify and implement all opportunities to collect this data year round. Creates and manages all aspect of related roadmaps and project plans, creates and implements training plans for auditors, over-reads auditors’ work, identifies and addresses auditors’ gaps in training/knowledge/skills, monitors and addresses auditors’ productivity issues. Using data, evidence-based techniques, and business (contractual) priorities, identify top opportunities to improve performance measure rates and communicates these in a clear and timely fashion to leadership.
Provide project management support to QM, which may include creating and monitoring tracking mechanisms and monitoring improvement initiatives. Project manage all aspects of CMS Stars data collection, submission and improvement.
This position may be located out of any of the following Health Choice offices: Flagstaff AZ, Phoenix AZ, Salt Lake City UT, Dallas TX, Needham MA. For candidates within commuting distance of those offices, remote work (telework) may be available based on business needs and job performance, after successful completion of an in-office training period.
Health Choice exists to improve the health and well-being of the individuals we serve through our health plans, integrated delivery systems and managed care solutions. We strive to recruit and retain only the finest health care professionals with the highest levels of integrity, compassion and competency. If you are driven by your own personal commitment to these values and desire to work in a team-focused, collaborative and supportive environment - while still being valued for your individual strengths - Health Choice is the place for you.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled
One for the following credentials is required: Bachelor's degree, RN, LPN, CPHQ, CCS, CCS-P, RHIT, RHIA, CDEO, CPMA, CPC, CRC, CHCA or similar credential
Seven (7) or more years of experience in health care quality focused roles that included medical record audits and/or performance metric i.e., HEDIS, Stars, or similar
Significant experience in quality measurement, HEDIS, interpretation of claims data, medical record review
Strong computer skills, i.e., using various software, including intermediate Excel skills (sort, filter, reformat data, etc.)
Strong analytic skills/ability to translate complicated data into useable information, including analysis of practice variation
Successful experience managing complex projects beginning to end with accountability for outcomes, demonstrated organizational and project management skills to manage complex projects through effective planning, tracking, and resource allocation to meet business objectives and timelines
Strong leadership and management skills; self-directed
Ability to generate creative solutions