Skip to main content

HEDIS Lead (US)

  • Job Family: Business Support
  • Type: Full time
  • Date Posted:
  • Req #: JR37588

Location:

  • Florida, Florida

Share:

Description

Location : This position is work from home and must be located in Miami, Florida.

Travel : Up to 75% travel, including some overnight, within the state of Florida.

Responsible for coordinating, implementing, and executing HEDIS Quality Department specific projects, ensuring consistency with company strategy, commitments, and goals.

Primary duties may include, but are not limited to:

  • Leads annual HEDIS medical record collection and abstraction process; synthesizes aggregate plan and product level data medical record data; establishes the baseline and measures the change, data gathering, presentation, and interpretation for optimal HEDIS data/results.
  • Prepares and maintains project plans and schedules inclusive of tasks, timelines, resources, milestones, dependencies, and assumptions.
  • Leads teams regarding work flow process improvement, document management, and abstraction education.
  • Trains and leads onsite temporary staff.
  • Evaluates and monitors performance and efficiency of programs to ensure that implementation meets targeted timelines.
  • Collaborates with multiple departments and external vendor to annually field a new HEDIS pursuit application.
  • Collaborates with external provider partners on quality improvement programs and initiatives.

Minimum Requirements: AA/AS in healthcare field and minimum of 2 years experience with HEDIS activity coordination or working with Managed/Acute/Provider Care environment, including 2 years of analytical experience; or any combination of education and experience, which would provide an equivalent background.

Preferred qualifications, skills, and experience : BA/BS preferred. RN, RHIA or RHI license preferred. NCQA experience preferred. Experience with Medicare Stars program, and population health strategy.


Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Be part of an Extraordinary Team

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

Apply Now