HEDIS Business Analyst

招聘企业
Prime Solutions, Inc.
工作地点
Minneapolis
薪金
Competitive
已发布
2019年9月10日
关闭
2019年9月24日
工作职责
会计师
行业
IT
合同类型
永久
工作时间
全职

Primary Responsibilities:

Source Management

  • Knowledgeable of supplemental data sources purpose, intent of use, data collection method
  • Responsible for audit documentation completion and quality of documentation
  • Responsible for medical record requests to support medical record review or primary source verification related to HEDIS audit
  • Knowledgeable of NCQA HEDIS technical specifications regarding supplemental data and applicable measures
  • Responsible for tracking of source documentation readiness

Data Management

  • Maintain documentation of end–to–end data flow of sources
  • Knowledgeable of data validation reports of sources
  • Awareness of data load to HEDIS rules engines

Audit Management

  • Maintain documentation of audit review outcome by source
  • SupportQuality Solutions Delivery with HEDIS audit for all audit groups involved with annual audit –– address audit issues/concerns within required turnaround time
  • Complete work on time, especially as it pertains to HEDIS audit deadlines

Other Responsibilities:

  • Develop & produce ad–hoc reports
  • Participate with complex analyses and reports
  • Works independently; seeks guidance on only the most complex tasks
  • Works collaboratively with other CDSM team members, Quality Solutions Delivery, SDR and PEDS teams
  • Support national projects /pilots

Qualifications:

  • 1+ years of experience with HEDIS documentation and auditing processes
  • 2+ years experience in Healthcare Industry with clinical data (non–claims), with a focus with understanding of medical terminology and clinical care
  • Excellent verbal and written communication skills; ability to speak clearly and concisely, conveying complex information in a manner that others can understand
  • A Bachelor's Degree

Competencies:

  • IntermediateMS Word and MS Excel skills
  • Advanced proficiency with MS Office (Including Outlook, PowerPoint, SharePoint)
  • Familiarity with MS Visio and MS Access
  • Proven ability to learn new technologies
  • Make fact–based decisions
  • Support change and innovation

Soft Skills:

  • Strong interpersonal skills
  • Ability to work independently towards common team goals
  • Team player
  • Strong communication skills
  • Organized
  • Ability to manage multiple projects at a time
– provided by Dice