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HEDIS Supervisor

Columbus, OH · Healthcare
HEDIS Supervisor – Health Plan
Columbus, OH

HEDIS Supervisor Job Summary:
  • Supervise and coordinate team to ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement opportunities.
  • Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization, maximizing opportunity to improve outcomes for members.
  • Coordinate activities, resources, methods, and procedures to achieve improvement in HEDIS measures with the business leaders and cross functional departments
  • Coordinate with the department leader to formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines
  • Supervise the daily activities of staff to promote quality improvement and efficient methods
  • Assist with comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures
  • Coordinate clinical quality metrics and HEDIS processes and results
  • Coordinate cross functional process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
  • Manager the coordinate HEDIS projects to include assignment of nurses, adherence to plan timelines, and vendor oversight for timeliness and quality
  • Ensure compliance for all quality audits and maintain all data and process controls
HEDIS Supervisor Background:
  • Bachelor’s Degree in nursing, health care management, public health, or related discipline is required; Master’s degree is a plus.
  • Requires at least 3 years of quality improvement, HEDIS project management or health care related experience.
  • Requires working knowledge of NCQA and HEDIS programs.
  • Knowledge of guidelines for Medicaid/Medicare and related state programs is required.
  • Ability to determine HEDIS compliance, with knowledge of key drivers for HEDIS, HOS and STAR measures.
  • Strong analytical mind, with problem solving and investigative skills, an aptitude for accuracy, and attention to detail; essential to evaluate data for accuracy and integrity.
  • Must be computer literate and knowledgeable in MS Office and program management software.
  • Possess superior verbal and written communication skills, able to interface with business and medical professionals.

480.269.9491 (CALL – TEXT – FAX)
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