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HEDIS Lead (Medicaid Medicare Program) - 133403 in Houston, TX at Anthem, Inc.

Date Posted: 2/10/2018

Job Snapshot

Job Description

Your Talent. Our Vision. At Anthem, Inc., it’s a powerful combination, and the foundation upon which we’re creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

HEDIS Lead (Medicare Medicaid Dual Eligible Program Unit)
Location:  May be located in Dallas or Houston
 
 
Responsible for coordinating, implementing, and executing HEDIS Quality Department specific projects, ensuring consistency with company strategy, commitments, and goals. Primary duties may include, but are not limited to:
 
  • Leads annual HEDIS medical record collection and abstraction process; synthesizes aggregate plan and product level data medical record data; establishes the baseline and measures the change, data gathering, presentation, and interpretation for optimal HEDIS data/results.
  • Prepares and maintains project plans and schedules inclusive of tasks, timelines, resources, milestones, dependencies, and assumptions.
  • Leads teams regarding work flow process improvement, document management, and abstraction education.
  • Hires, trains, and supervises onsite temporary staff.
  • Evaluates and monitors performance and efficiency of programs to ensure that implementation meets targeted timelines.
  • Collaborates with multiple departments and external vendor to annually field a new HEDIS pursuit application.

Job Requirements

Requires an AD in healthcare field; 2 years of experience with HEDIS activity coordination or working with Managed/Acute/Provider Care environment, including 2 years of analytical experience; or any combination of education and experience, which would provide an equivalent background.   Must have HEDIS experience. 

Preferred
NCQA experience  
BA/BS preferred. RN, RHIA or RHI license 
Medicare, Medicaid, or experience with dual eligible programs

 
Anthem, Inc. is ranked as one of America’s Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

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