• Job Description

  Req#: JR86054

  Position Title:

  Director, HEDIS Quality

  Job Description:

  Director, HEDIS Quality

  The Director, HEDIS Quality is responsible for strategic and tactical leadership for the centralized Enterprise Healthcare Effectiveness Data and Information Set (HEDIS) data collection processes for all lines of business.

  How you will make an impact:

  • Develops annual HEDIS data collection strategy.
  • Manages teams responsible for capturing and maximizing HEDIS data for Commercial & Medicare and Medicaid.
  • Compiles individual data results into user-friendly reports; interprets data and data requirements for customers.
  • Manages vendors and negotiates and executes contracts.
  • Oversees third party audits and serves as subject matter expert.
  • Establishes process for RFP/RFI/RFS responses related to HEDIS data.
  • Ensures compliance with state and regulatory requirements.
  • Hires, trains, coaches, counsels, and evaluates performance of direct reports.

  Minimum Qualifications:

  • Requires a BA/BS degree in a clinical or health related field; 7 years of experience including 5 years of management experience in a health care environment and 2 years of HEDIS process management experience; or any combination of education and experience, which would provide an equivalent background.

  Preferred Skills, Capabilities and Experiences:

  • MS or advanced degree in a health care or business related field preferred.
  • Primary Source Verification experience.
  • Experience with year-round supplemental data collection.
  • Clinical Data Exchange experience i.e., EMR, SFTP and ROI, strongly preferred.
  • Analytical/data analysis skill set including strong Excel and Access experience.
  • Process Improvement experience using various technologies/software such as AI and LMM. Cotiviti experience preferred.
  • Strong leadership and communication skills with ability to collaborate cross functionally at all levels.

  For candidates working in person or remotely in the below locations, the salary* range for this specific position is $131,360 to $248,270.

  Locations: California; Colorado; Nevada; Washington State; Jersey City, NJ; New York City, NY; Ithaca, NY and Westchester County, NY

  In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws.

  *The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company’s sole discretion, consistent with the law.

  Job Level:

  Director

  Workshift:

  Job Family:

  QLT > Quality Assurance

  Be part of an Extraordinary Team

  Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. A Fortune 20 company with a longstanding history in the healthcare industry, we are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?

  We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

  Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

  The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.

  Elevance Health has been named as a Fortune Great Place To Work in 2022, has been ranked for five years running as one of the 2023 World’s Most Admired Companies by Fortune magazine, and is a growing Top 20 Fortune 500 Company. To learn more about our company and apply, please visit us at careers.ElevanceHealth.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact ability@icareerhelp.com for assistance.

• About the company

  Elevance Health, Inc. is an American health insurance provider.

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