Hedis Analyst in Glen Allen, VA at APEX Systems

Date Posted: 1/19/2020

Job Snapshot

Job Description

Job #:  1034975


Apex Systems is currently supporting a remote HEDIS Analyst for one of our clients. Please see below the job details and send your resume to agromovsky@apexsystems.com
SUMMARY:
This analyst is responsible for HEDIS Operations project support and coordination of the development and implementation of programs and strategies to improve service to our customers.
 
RESPONSIBILITIES/TASKS:
  • Coordinates client HEDIS projects and analysis for management and team
  • Prepares and manages detailed project timelines and diligently tracks deliverables to clients and auditors to meet strict deadlines.Participates in client onsite visits with the NCQA certified auditor.
  • Participates in medical record audits for supplemental data and MRR.
  • Acts as a key contributor during the MRR project by reporting and monitoring hybrid measure rate performance, overseeing vendor performance, retrieval status and issues, and appropriately handling any issues that may arise.
  • Assist with developing and deploying annual inter-rater reliability testing and training.
  • Develops and improves work flows and business processes within area(s) to improve customer service, decrease operational costs, and improve overall quality.
  • Identifies and/or analyzes business problems and devise procedures for solutions to the problems.
  • Effectively leads projects in order to produce desired results.
  • Recommends and assists with implementing standard policies and procedures.
  • Assures that corporate compliance is communicated, implemented, and monitored on an ongoing basis.
  • Participates in systems testing, develops procedures/controls, and provides recommendations for the ongoing improvement of the updated process.
  • Assists personnel (both internal and external) by answering questions, supplying information, and training.
  • Develops and maintains an effective working relationship with clients.
  • Participates in team discussions.
  • Develops documentation, reports and presentations for all levels within the organization including executive leadership.
  • Collaborates with Subject Matter Experts to develop and/or complete documents including the NCQA HEDIS ROADMAP.
  • Completes ad hoc data requests as assigned. Responsible for identifying, collecting, analyzing, and maintaining data to evaluate issues that support prospective business decisions.
  • Coordinates projects and analysis for management and team.
  • Ensures complete, accurate and timely data for reporting purposes.
  • Researches, analyzes, identifies, and evaluates data from assigned problems to evaluate existing and potential trends and issues.

EMPLOYMENT QUALIFICATIONS:
EDUCATION:
Bachelor's degree in a related field. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.
 
EXPERIENCE:
Two (2) to four (4) years experience in related field. Analyst experience required with proven experience in operational analysis, data analysis, and problem resolution type activities.
 
SKILLS/KNOWLEDGE/ABILITIES (SKA) REQUIRED:
  • Knowledge of HEDIS technical specifications, hybrid measures and HEDISprocess.
  • 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 control projects.
  • Excellent written and verbal communication skills.
  • Ability to lead and contribute to process improvement projects.
  • Ability to read and interpret documents such as data flows, process flows, technical diagrams, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups of customers or employees of organization.
  • Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
  • Administer and adhere to corporate and departmental policies, practices and procedures.
  • Knowledge of healthcare information technology and HEDIS medical record review process
  • Strong knowledge and use of Microsoft PowerPoint and Word
  • Advanced Microsoft Excel skills -- pivot tables, complex formulas, macros, etc.
  • Strong analytical, organizational, planning, and problem-solving skills.

 
 
 
 
 
 
 
 
 
EEO Employer
Apex Systems is an equal opportunity employer. We do not discriminate or allow discrimination on the basis of race, color, religion, creed, sex (including pregnancy, childbirth, breastfeeding, or related medical conditions), age, sexual orientation, gender identity, national origin, ancestry, citizenship, genetic information, registered domestic partner status, marital status, disability, status as a crime victim, protected veteran status, political affiliation, union membership, or any other characteristic protected by law. Apex will consider qualified applicants with criminal histories in a manner consistent with the requirements of applicable law. If you have visited our website in search of information on employment opportunities or to apply for a position, and you require an accommodation in using our website for a search or application, please contact our Employee Services Department at 844-463-6178.