HEDIS Operation Manager/Analyst

Overview

Remote
Depends on Experience
Accepts corp to corp applications
Contract - W2
Contract - Independent
Contract - 12 Month(s)
No Travel Required
Unable to Provide Sponsorship

Skills

HEDIS
NCQA
EDI
HL7
SQL
Power BI
SSRS

Job Details

Skills:

Strong data interpretation and analytic skills

Workflow/process development

NCQA/HEDIS specifications knowledge

Cross-functional communication

Strong SQL skills with Power BI and SSRS (Paginated Report) experience

Knowledge of different file formats (Standard and Non-Standard) such as EDI, HL7 and custom files

 

Responsibilities:

Support accurate HEDIS data collection, abstraction, and reporting.

Interpret and apply NCQA HEDIS technical specifications and measurement requirements.

Monitor, track, analyze, and report HEDIS performance metrics

Develop, maintain, and improve operational workflows and processes.

Manage data quality, validate measure logic, and prepare metrics for reporting and audits.

Coordinate end-to-end HEDIS processes, including chart chase/abstraction and vendor management

Partner with clinical and operational teams, vendors, and systems to ensure data integrity and completeness.

Track performance trends and identify opportunities for compliance improvement measures.

Support HEDIS audit activities end-to-end including proper documentation and artifacts.

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