Job details

Enterprise HEDIS Data Analyst II

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Job Summary:

The Enterprise HEDIS Data Analyst II performs analysis of all HEDIS data information, out of and within CareSource, in support of HEDIS performance measures and accreditation requirements

Essential Functions:

Work collaboratively with IT, Quality Improvement and other operational business owners to complete HEDIS analysis, program development and implementation to support coding as it relates to HEDIS
Identify and quantify HEDIS data issues within the organization and assist in the development plans to resolve these issues
Monitor the quality of HEDIS data and invoices submitted and received
Process weekly/monthly market files for ingestion into HEDIS tool
Assist with retrieval and abstraction of HEDIS records
Responsible in ensuring HEDIS data is submitted both timely and accurately to all applicable governing bodies
Work with Quality Improvement, IT and other operational business owners to ensure accuracy of HEDIS data
Responsible for working with HEDIS team to identify HEDIS analytics to drive HEDIS efficiencies
In conjunction with the HEDIS management team ensures alignment of all interventions with the HEDIS Strategic Plan
Maintain an understanding of Federal and State Regulatory requirements, i.e., CMS, ODM and other regulatory bodies
Review and maintain newsletter material, Provider Tools, CareSource Quality Improvement Job Aids, etc. to ensure they are kept current with Annual NCQA HEDIS Technical Specification updates
Support regular HEDIS data processes and market/vendor HEDIS requests
Perform all job functions with a high degree of discretion and confidentiality in compliance with federal, state and departmental confidentiality guidelines
Perform any other job duties as requested

Education and Experience:

Bachelor’s Degree in business, healthcare administration, or related field, or equivalent years of relevant work experience is required
Minimum of two (2) years of experience working with data and/or performing analysis using data and analytic tools is required
Managed Care experience preferred

Competencies, Knowledge and Skills:

Intermediate proficiency in Microsoft Word, Excel, and SharePoint preferred
Data analysis and trending skills
Excellent written and oral communications skills
Ability to work independently and within a team environment
Decision making/problem solving skills
Knowledge of Medicaid/Medicare preferred
Familiarity with healthcare field preferred
Proven understanding of database relationships
Knowledge of structured query language strongly preferred
Knowledge of NCQA/HEDIS
Excellent customer service skills
Critical listening and thinking skills
Ability to manage and meet workloads and deadlines

Licensure and Certification:

None

Working Conditions:

General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

$61,500.00 - $98,400.00

CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. In addition to base compensation, you may qualify for a bonus tied to company and individual performance. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.

Compensation Type (hourly/salary):

Salary

Organization Level Competencies

Create an Inclusive Environment
Cultivate Partnerships
Develop Self and Others
Drive Execution
Influence Others
Pursue Personal Excellence
Understand the Business

This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.

Average salary estimate

$79950 / YEARLY (est.)

min

max

$61500K

$98400K

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What You Should Know About Enterprise HEDIS Data Analyst II, CareSource

At CareSource, we’re all about making a difference, and we’re currently on the lookout for an Enterprise HEDIS Data Analyst II to join our dynamic team! In this exciting role, you will dive deep into the analysis of HEDIS data, ensuring our performance measures and accreditation requirements shine. You’ll work closely with IT and Quality Improvement teams, collaborating to tackle HEDIS-related challenges and implement effective solutions. Your analytical skills will be put to the test as you identify and address data issues, monitor HEDIS data quality, and ensure all submissions are timely and accurate. Your attention to detail will be key as you support HEDIS record abstraction and assist in driving HEDIS efficiencies. You’ll also maintain current with regulatory requirements and make sure our documentation is up-to-date with NCQA specifications. If you're passionate about healthcare data, enjoy working in a team environment, and possess strong communication skills, we want to hear from you! Join us at CareSource, where your contributions can lead to meaningful changes in the lives of those we serve.

Frequently Asked Questions (FAQs) for Enterprise HEDIS Data Analyst II Role at CareSource

What are the responsibilities of an Enterprise HEDIS Data Analyst II at CareSource?

As an Enterprise HEDIS Data Analyst II at CareSource, you'll be responsible for performing in-depth analyses of HEDIS data both within the organization and across various operational units. You will work collaboratively with IT and Quality Improvement teams to support program development and ensure compliance with accreditation requirements. This includes monitoring data quality, addressing issues, and ensuring timely submissions to regulatory bodies.