Manager, HEDIS Operations – Non-Clinical
Centene Corporation
full-time
Posted on:
Location Type: Remote
Location: Remote • Florida, Missouri, Ohio, Pennsylvania, Wisconsin • 🇺🇸 United States
Visit company websiteSalary
💰 $86,000 - $154,700 per year
Job Level
Mid-LevelSenior
About the role
- Oversee and 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.
- Oversee activities, resources, methods, and procedures to achieve improvement in HEDIS measures.
- Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals.
- Provide comprehensive analysis of HEDIS measures, barriers, and opportunities and present results to senior management.
- Manage all clinical quality metrics and HEDIS processes and results.
- Implement process to request and evaluate member compliance reports for each HEDIS measure.
- Oversee all HEDIS projects to include assignment of nurses and vendor oversight for timeliness and quality.
- Ensure compliance for all quality audits and maintain all data and process controls.
- Performs other duties as assigned.
Requirements
- Bachelor's degree in Business Administration, Health Care Administration, Health-Related field, or equivalent experience.
- 4+ years of HEDIS project management or healthcare management experience.
- Advanced working knowledge of HEDIS technical specifications.
- Quality improvement experience preferred.
- Master’s degree preferred.
Benefits
- competitive pay
- health insurance
- 401K and stock purchase plans
- tuition reimbursement
- paid time off plus holidays
- flexible approach to work with remote, hybrid, field or office work schedules
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard skills
HEDIS data accuracyHEDIS technical specificationsquality improvementdata analysisauditingreportingclinical quality metricsprocess evaluationproject managementcompliance reporting
Soft skills
collaborationcommunicationleadershiporganizational skillsproblem-solvingpresentation skillsstakeholder managementresource managementanalytical thinkingattention to detail