HEDIS Analyst

HEDIS Analyst

Lead II - Business Analysis

Who we are:

Advantasure is a growing company and a member of the UST HealthProof family, Advantasure champions innovative solutions with an eye on the future—providing health plans with the flexibility to adapt to a changing regulatory environment and evolving business needs. Leveraging the industry’s leading experts in government-sponsored health plans, Advantasure offers solutions for administrative cost management, quality patient outcomes and experiences, enrollment growth, risk adjustment, and quality and provider engagement initiatives.

We achieve this mission together through teamwork, communication, collaboration, and focus. Our employees are our greatest assets, and we invite you to apply to be a part of our journey toward making a difference in healthcare in the United States.

You are:

The Analyst - HEDIS is a role responsible for HEDIS Operations project support. This primarily includes support during the HEDIS and Supplemental Data seasons by performing medical record review abstraction and assisting in audit activities, and coordinating the development and implementation of programs and strategies to improve service to our customers.

The Opportunity:

• Maintains a comprehensive understanding and knowledge of HEDIS Medical Record Review activities – specifically client abstractions, data audit, and HEDIS/Stars technical specifications.
• Assists with ongoing abstraction and overread activities in support of the clients during the HEDIS medical record review and Supplemental data seasons.
• Collaborates with coordinators on HEDIS audit submissions for all clients.
• Effectively support a broad range of HEDIS clients and products.
• Coordinates across teams to collect data for the Quality Program projects to be used for analysis by internal and external teams.
• Develops and maintains an effective working relationship with customers and internal business partners.
• Represents and participates in group or committee discussions.
• Develops documentation, reports, and presentations for all levels within the organization including executive leadership and clients.
• Collaborates with Subject Matter Experts to develop accurate documents.
• Communicates results of the analysis to management and clients via reports/presentations and assists management in implementing programs that provide solutions.
• Assists in the management and monitoring of multiple HEDIS projects simultaneously by establishing objectives to ensure goal attainment within defined parameters.
• Communicates results of the analysis to management and clients via reports/presentations and assists management in implementing programs that provide solutions.
• Contributes to and leads projects that have been identified to improve efficiency and accuracy.
• Researches, analyzes, identifies, and evaluates data that supports clients’ troubleshooting needs and prospective business decisions.
  

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.

What you need:

• Bachelor’s degree in Business Administration, Economics, Mathematics, Statistics, Health Care, or a related field is required.
• Continuous learning, as defined by the Company’s learning philosophy, is required. Certified Analytics Professional (CAP) or Certified Professional in Healthcare Quality (CPHQ) is highly preferred and encouraged.
• 1-3 years of experience in a related field.
• Analyst experience required with proven experience in medical record review abstraction and overreading, operational analysis, data analysis, and problem resolution-type activities.
• Knowledge of the HEDIS medical record review guidelines, requirements, and process.
• Knowledge of products reported for HEDIS.
• Ability to effectively learn and stay up to date on new technical specifications and how it translates to medical record review, reporting, and analysis.
• Self-starter that is comfortable with ambiguity and has the ability to identify, implement, and execute business strategies.
• Excellent 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 troubleshoot issues in support of internal and external projects.
• Strong written and verbal communication skills are required to understand, interpret, and communicate ideas.
• Ability to lead and contribute to process improvement projects.
• Ability to read and interpret documents such as data flows, process flows, and operational reporting.
• Ability to speak effectively before groups of customers or employees of an organization.
• Administer and adhere to corporate and departmental policies, practices, and procedures.
• Strong knowledge and use of existing software packages (PowerPoint, Excel, Word).
• Experience executing in a fast-paced environment with tight deadlines.
  

Compensation can differ depending on factors including but not limited to the specific office location, role, skill set, education, and level of experience. As required by local law, UST HealthProof provides a reasonable range of compensation for roles that may be hired in California, Colorado, New York City or Washington as set forth below.

Role Location: Range of Starting Pay for Role

Remote: $55,000-$70,000

Our full-time, regular associates are eligible for 401K matching, and vacation accrual and are covered from day 1 for paid sick time, healthcare, dental, vision, life, and disability insurance benefits. Depending on the role, some associates may also be eligible for stock options.

What we believe:

We’re proud to embrace the same values that have shaped UST and its subsidiaries since the beginning. Since day one, we’ve been building enduring relationships and a culture of integrity. And today, it's those same values that are inspiring us to encourage innovation from everyone to champion diversity and inclusion and place people at the center of everything we do.

Humility: We will listen, learn, be empathetic, and help selflessly in our interactions with everyone.

Humanity: Through business, we will better the lives of those less fortunate than ourselves.

Integrity: We honor our commitments and act with responsibility in all our relationships.

Equal Employment Opportunity Statement

UST HealthProof is an Equal Opportunity Employer.

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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