HEDIS Coordinator Job Listing at HCSC in Chicago, IL (Job ID R0039407)

Description

At HCSC, our employees are the cornerstone of our business and the foundation to our success. We empower employees with curated development plans that foster growth and promote rewarding, fulfilling careers.

Join HCSC and be part of a purpose-driven company that will invest in your professional development.

COMPENSATION APPROVAL REQUIRED FOR POSTING. This Position Is Responsible For Coordinating And Completing The Annual Analysis And Submission Of Hedis Information To Ncqa. Responsible For Coordinating Activities Of Internal Departments, External Partners, And External Vendors Also Responsible For Providing Support In The Planning, Coordinating, And Validating Quarterly Crms Database Builds.

• Coordinates and completes the annual analysis and HEDIS Medical record data collection and submission to NCQA.
• Support and ensure accuracy/compliancy during the NCQA required MRRV audit
• Coordinates the yearly HEDIS Survey Audit activities of internal departments (Quality, Nurses, Network, Communication/Publications), external provider partners , and contracted vendors (NCQA,).
• Responsible for HEDIS QI Work Plan management and revisions and IL Annual HEDIS Report.
• Attend Quality Improvement Committee and present dashboard on HEDIS and Pay for Performance annual analysis
• Participate in QI activities (Pay for Performance, HEDIS workgroup, CAHPS workgroup)
• Conduct oversee and monitor HEDIS activities throughout the year including submission/presentation of HEDIS reports to health plan quality committees, develop/monitor HEDIS timelines and annual Roadmap revisions.
• Conduct analysis of data and complete annual HEDIS and Pay for Performance reports and playbook
• Conduct HEDIS training for internal and external Quality staff
• Participate in HEDIS temp selection including resume review, interviewing and partnering with plan leadership and External Workforce Services on candidate recommendations
• Serve as liaison between the Enterprise and Illinois Plan
• Monitors NCQA and HEDIS program specifications and translate into report requirements.
• Maintains knowledge of HEDIS report software.
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company business.
• Maintain communication with management regarding development within areas of assigned responsibilities and perform special projects as required or requested.

JOB REQUIREMENTS:

• Registered Nurse (RN) or Clinician with unrestricted, Active license in state of operations
• Bachelor's degree in a related field
• Knowledge of HEDIS Technical Specifications, guidelines and HEDIS survey process
• Minimum of 2 years experience with data analysis.
• Minimum of 2 years in a health care environment.
• Experience with NCQA Survey Requirements and HEDIS reporting.
• Experience utilizing various software packages including Excel, Access, and Word
• QSHR expertise including chase management, report queries, data analysis and clinical assignments

PREFERRED JOB REQUIREMENTS:

• Project Management Experience
• Ability to interpret Quality Compass and understand IDSS rates
• Skilled at managing multiple competing projects in a fast-paced environment with problem-solving abilities
• Health plan knowledge including LOB/products
• Exceptional communication and collaboration skills

#LI-Hybrid

*This role is a hybrid - 3 days in office 2 days work from home at our 300 E. Randolph Location

Compensation: $60,300.00 - $133,400.00

Exact compensation may vary based on skills, experience, and location

HCSC Employment Statement:

We are an Equal Opportunity Employment / Affirmative Action employer dedicated to providing an inclusive workplace where the unique differences of our employees are welcomed, respected, and valued. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status, or any other legally protected characteristics.

To learn more about available benefits, please click https://careers.hcsc.com/totalrewards

 Apply on company website