Das ist der Job
Responsibilities Support HEDIS measurement, reporting, validation, and annual submission activities.
Darum lohnt es sich
Partner with quality, population health, provider engagement, and care management teams to support HEDIS initiatives. Interpret HEDIS measure specifications and translate business requirements into data and reporting solutions. Analyze HEDIS performance results and identify opportunities to improve quality scores and close care gaps.
Assist with HEDIS audits, documentation reviews, and quality assurance activities. Gather, analyze, document, and validate business requirements from health plan stakeholders. Perform root cause analysis on data quality issues impacting HEDIS, CMS reporting, and operational performance.
Develop source-to-target mappings, business rules, process flows, and functional specifications. Analyze large healthcare datasets and present findings, trends, and recommendations to business stakeholders. Support UAT testing, reconciliation, defect resolution, and deployment validation activities.
Analyze claims, encounters, eligibility, provider, pharmacy, and supplemental data used for HEDIS and CMS reporting. Validate data completeness, accuracy, reconciliation results, and reporting outputs. Support CMS quality initiatives, STAR Ratings programs, and regulatory reporting requirements. Collaborate with business
