Manager, HEDIS & Quality Improvement Analytics Job Listing at Medical Mutual in Brooklyn, OH (Job ID 2400637)

Description

Ohio residents and residents of states that border Ohio are preferred due to the on-site frequency this role requires. 

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.6 million Ohioans through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans.

Medical Mutual' s status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us and help our members achieve their best possible health and quality of life.

Manages all aspects of Healthcare Effectiveness Data and Information Set (HEDIS) functions including planning, data collection and submission, quality control, and reporting and analysis to meet all requirements of the National Committee on Quality Assurance (NCQA), regulatory agencies, and the health plan's strategies, goals, and initiatives for all lines of business (Commercial, Marketplace and Medicare Advantage). Manages reporting and analyses of quality measurement results (including, but not limited to HEDIS, STARS, CAHPS and HOS) to identify actionable opportunities for quality improvement. Serves as a quality measurement and improvement subject matter expert and as a key member of the corporate quality improvement committee.  Manages staff to identify actionable improvement opportunities, convey results to key stakeholders, recommend appropriate interventions and initiatives, and evaluate their effectiveness.

Responsibilities

·    Manages the HEDIS annual submission process.  Develops and manages detailed work plans.  confirms integrity of supplemental data sources, and data exchanges with vendor. Leads the process for defining operational improvements within the health plan following the annual HEDIS audit. 

·    Manages staff creating reports for internal use and regulatory submissions.  Oversees staff to identify and communicate opportunities for improvement, and evaluation of outcomes.  Ensures integrity of analytic work products.

·    Serves as a subject matter expert regarding measurement, quality improvement opportunities and approaches, analytics, interventions and initiatives and evaluation of improvement activities.  Provides oversight, training, and development to staff.  Maintains strong knowledge of regulatory requirements, quality rating systems, and measure technical specifications.

·    Builds and maintains relationships with internal and external customers.  Communicates progress and results through presentations to key stakeholders, including senior leadership.

·    Performs other duties as assigned.

Qualifications

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

• We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
• Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
• On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
• Discounts at many places in and around town, just for being a Medical Mutual team member.
• The opportunity to earn cash rewards for shopping with our customers.
• Business casual attire, including jeans.

Excellent Benefits and Compensation:

• Employee bonus program.
• 401(k) with company match up to 4% and an additional company contribution.
• Health Savings Account with a company matching contribution.
• Excellent medical, dental, vision, life and disability insurance insurance is what we do best, and we make affordable coverage for our team a priority.
• Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
• Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
• After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

• Career development programs and classes.
• Mentoring and coaching to help you advance in your career.
• Tuition reimbursement up to $5,250 per year, the IRS maximum.
• Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutuals status as a mutual company means we are owned by our policyholders, not stockholders, so we dont answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

Theres a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

Were not just one of the largest health insurance companies based in Ohio, were also the longest running. Founded in 1934, were proud of our rich history with the communities where we live and work.

At Medical Mutual and its family of companies we celebrate differences and are mutually invested in our employees and our community. We are proud to be an Equal Employment Opportunity and Affirmative Action Employer. Qualified applicants will receive consideration for employment regardless of race, color, religion, sex, sexual orientation, gender perception or identity, national origin, age, marital status, veteran status, or disability status.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.