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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ReqRoute, Inc is an Equal Opportunity Employer. Qualified applicants will receive consideration for employment without regard to race, color, religion, sex, age, disability, military status, national origin or any other characteristic protected under federal, state, or applicable local law. (www.reqroute.com)
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