Responsible for creating and facilitation training strategies/programs to support an operational team responsible for abstraction and pursuit of HEDIS® measures to ensure they reach operational milestones, gap closures, rates and overall successful quality standards
How You Will Make an Impact:
Manages, coordinates and facilitates HEDIS® training, including HEDIS® software training, admin and hybrid measure training and creating training materials
Coordinates training related to external client facing program; develops program success measures and performs periodic assessments of program success.
Assures compliance with corporate QI work plans.
Assures that all QI activities are relevant to the needs of targeted population.
Maintains effective documentation of research programs to meet regulatory and Accreditation Standards.
Provides oversight to assure accurate and complete quantitative analysis of clinical data and presentation of data analysis results.
Participates in and provides input to the development of new product designs for major line of business.
Oversees the implementation of new initiatives.
Leads interactions with regulators or oversight entities.
Oversees quality improvement activities for the largest, most complex state programs.
Required Qualifications:
Requires a BS in health administration, nursing, or a related clinical field; 4 years of health care quality or data analysis experience; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications:
Previous HEDIS® measure training experience including HEDIS® software workflow development
Previous experience working with HEDIS chart retrieval, abstraction and over-reading
Previous experience working Cotiviti HEDIS software is strongly preferred
Expert knowledge with HEDIS® technical specifications preferred
Expert knowledge with HEDIS® value sets and coding preferred
