1044 Hedis Subject Matter Expert

Location: Minnetonka, MN, United States
Date Posted: 09-04-2018
Job Title: HEDIS SME
Location : Minnetonka – MN (Onsite OR Remote)
Rate: Market Rate
Duration: 6+ Months
Job Roles/Responsibilities:
Experience as a primary HEDIS subject matter expert with a minimum of 8-10 years of experience in HEDIS submissions (Medicaid, Medicare and Commercial submissions to NCQA) and Medicare Star assessment.
  •          Strong in SQL,SSIS, Reporting  as technology. Self-driven, motivated, willingness to work on an onsite/offshore model
  •          Direct and guide team of analysts which research issues and conduct root cause analysis for HEDIS measure improvement.
  •          Implement processes and solutions based on data driven decision making.
  •          Develop business processes and implement technology solutions to maximize HEDIS/Medicare star rates.
  •          Experience in performance analysis on HEDIS accreditation and Medicare Star.
  •          Oversee creation and maintenance of Medicare Star dashboard.
  •          Responsible for tracking, analyzing and trending data.
  •          Maintain and monitor HEDIS project plan to ensure that all deadlines are met
  •          Provide use cases and technical solution approach to HEDIS/Medicare Star enterprise projects.
  •          Manage data mining activities with the goal of creating supplemental databases to be used for our HEDIS audit.
  •          Develop policy and procedures with the goal of maximizing HEDIS rates.
  •          Experience in Medical Record Retrieval (MRR) process, IDSS, MLD.
  •          Investigate and resolve systems issues relating to the certified software used during the HEDIS audit.
  •          Responsible for collecting, tracking, trending HEDIS data, and the management and implementation of the HEDIS data collection software.
  •          Lead and participate in projects with internal and external entities aimed at improving our HEDIS rates.
  •          Recommend solutions based on data analysis to increase business efficiency and improve existing processes.
  •          Experience in data mining, SQL complex queries and business intelligence strategies to determine optimal data sources for reporting of member and provider data
  •          Able to participate and lead the communications with customer team, business users and MRR vendors and ensure the projects are on track to meet the timelines
  •          Coach and mentor less experienced staff and assist in training of new staff.
  •          Should be able to provide guidance to the internal team members and the product team with the HEDIS best practices, current trends, methods and processes
 Please reach me at gaurav@reqroute.com or call 669-232-1044
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