AmeriHealth Caritas HEDIS Analyst in Philadelphia, Pennsylvania

HEDIS Analyst

Location: Philadelphia, PA

Telecommuter?: Yes

ID**: 14304

Job Brief

Manage the HEDIS lifecycle process for multiple plan

Your career starts now. We’re looking for the next generation of health care leaders.

At AmeriHealth Caritas, we’re passionate about helping people get care, stay well and build healthy communities. As one of the nation's leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we’d like to hear from you.

Headquartered in Philadelphia, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services. Discover more about us at www.amerihealthcaritas.com .

Supports corporate, plan-level, and departmental strategies and goals for HEDIS process. Meets this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems.

Essential Functions include but not limited:

  • Manage the HEDIS lifecycle process for multiple plans.

  • Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations.

  • In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs.

  • Assist in preparation for the HEDIS audit.

  • Develop and maintain HEDIS based report to support Quality Initiatives.

  • Represent HEDIS team in collaboration with internal departments for HEDIS improvement.

  • Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.

  • Assists as necessary in the HEDIS Road Map and all other documents required by auditors.

  • Able to assimilate into team within minimum amount of assistance

  • Assures the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers.

  • Experience and ability to utilize a certified HEDIS software.

Education & Experience:

  • Bachelor’s degree required with a concentration in health care related field, Master’s degree is preferred

  • Minimum 1 year HEDIS experience required; 2+ years’ experience with HEDIS preferred.

  • Minimum 5 years of work experience in healthcare and/or managed care

  • Other skills:SQL and / or SAS experience required

  • Opportunity to work remotely commensurate to HEDIS experience

EOE Minorities/Females/Protected Veterans/Disabled