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Job Description
- Req#: JR84384
- Primary duties may include, but are not limited to: Leads and manages annual HEDIS process within plan or region; serves as subject matter expert to enterprise team.
- Identifies, develops, and improves processes, procedures, and operations, conducts analysis, leads cross functional teams, and schedules, develops, and implements initiatives to strategically improve project processes.
- Secures and coordinates resources, temporary staff, space and equipment, and system requirements.
- Evaluates and monitors performance and efficiency of programs to ensure that implementation meets targeted timelines.
- Develops strategy with multiple enterprise departments and external vendor to annually field a new HEDIS pursuit application.
- Synthesizes performance data, prepares presentation materials, and presents comparative complex reports to local and enterprise quality committees.
- Builds relationships with internal and external customers.
Position Title:
HEDIS Manager (US)Job Description:
The HEDIS Manager is responsible for coordinating, implementing, and executing HEDIS Quality Department specific projects, ensuring consistency with company strategy, commitments, and goals.
Minimum Requirements
Requires a BA/BS in public health, nursing or related field and minimum of 5 years experience involving direct health care background and analyses of health care data, including 1 year of experience with HEDIS activity coordination and experience working with Managed/Acute/ Provider Care environment; or any combination of education and experience, which would provide an equivalent background.
Preferred Qualifications
Masters in Public Health, Health Services Administration, Nursing, or Business Administration preferred. RN, RHIA or RHIT and CPHQ license preferred. NCQA experience preferred.
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $72,280 to $112,920
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:
Non-Management ExemptWorkshift:
Job Family:
BSP > Business SupportBe 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.