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Quality Analyst

Job Posting
Quality Analyst-Remote
Job Details
Job Type

Full-time

Greensboro, NC • Medcare STARS
Description
Job Summary

The Quality Analyst is responsible for managing and processing the plans of Quality and STARs programs with the execution of the HEDIS functions, projects, roadmap development, reporting, audit, and submissions. This position will provide oversite and assistance to the delegated partner responsible for abstracting data, formatting data, and submitting data to ensure that the data submitted is accurate and meets all regulatory deadlines and requirements. The Quality Analyst will help implement strategies to achieve desired quality and HEDIS measures.

Major Work Activities

Managing and processing the annual development and submission of the Plan’s HEDIS Roadmap in conjunction with HTA’s delegated partners, to include coordination/tracking of the completion of each section per NCQA’s requirements.
Responsible for the tracking of HEDIS measures through HEDIS software and reporting; and identifying/resolving issues related to processing, data, and/or HEDIS program as required for both internal and external reporting requirements.
Collaborate with the operations, delegated partners, and external vendors throughout HEDIS season/audit, including but not limited to collection, tracking, and summarizing the information related to the activities of the HEDIS program in order to support the tracking and analyzing of HEDIS measures.
Responsible for the review, resolution, and submission of updates related to HEDIS filing errors in conjunction with HTS’s delegated partners.
Support and participate in improving HEDIS measures identified by Quality.
Responsible for identifying trends or areas of concern of HEDIS data supplied by HTA’s delegated partners, including the accuracy and validity of source data and results.


Requirements
Requirments

Minimum Qualifications

Education

Bachelor’s Degree or four (4) or more years equivalent work experience

Licensure/Certification

Annual Flu Vaccine

COVID-19 Vaccine

Experience

Two (2) or more years experience in health insurance
Proficient in Word, Excel, and PowerPoint
Experience working with vendors/delegated entities
Demonstrated organization and facilitation, communication and presentation skills
Knowledge, Skills, and Abilities

Knowledge of applicable Medicare Advantage requirements

Strong in the following competencies:

Decision making/Judgment
Problem solving/Analysis
Communication
Creativity/Innovation Strong project management skills
Ability to work independently

Preferred Qualifications

Education

Bachelor’s Degree in business or health-related field

Experience

Two (2) or more years of Medicare Advantage HEDIS experience
Experience working with regulatory agencies and compliance environment
Experience coordinating/project managing initiatives
Experience interacting with healthcare professionals, auditors, external vendors, and CMS.
Preferred Knowledge, Skills, and Abilities

Knowledge of HEDIS requirements

Strong in the following competencies:

Time:  Full time
Salary:  Salary
Category:  Administration

Updated: 12/10/2021 12:49:18 PM

Job Contact:
Michael Abner
3364483122

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7800 McCloud Road
Greensboro, NC 27409

3364483122