Responsible for the collection and analysis of operational and quality data related to HEDIS® (Healthcare Effectiveness and Data Information Set) and other quality measures; preparing recommendations based on data; assisting with identification and follow through of quality projects related to HEDIS® measures; assisting in the preparation of yearly HEDIS® projects; assuring compliance with HIPAA Privacy Standards, Medicare Standards, BMS Standards and NCQA Standards.
- College degree in quantitative, communications or health-related field; statistical knowledge preferred;
- Effective written and verbal communication skills;
- Computer application skills including Excel, Word, etc.;
- Ability to plan, execute and complete long-term projects;
- Experience with automated information systems and computer generated data;
- Strong analytic skills;
- Ability to work independently as well as part of a team.
- Knowledge of HEDIS® and Star Ratings;
- Prior Managed Care experience;
- Medical terminology.