Virginia Premier Health Plan, Inc.

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HEDIS Analyst I

HEDIS Analyst I

Job Locations 
US-VA-Glen Allen
Job ID 
2017-4264

Job Description

Overview

The HEDIS Analyst I position provides support with the HEDIS reporting application, developing an extensive expertise in collection and analysis of data, and collaborating with the Quality and Pay for Performance Team. In this analytical position, you will support continuous improvement in all technical and reporting aspects of HEDIS and all related activities. This position will assist with the planning, and developing enhancements to the application by working with vendors as well as applying upgrades, service packs and hot fixes. The HEDIS Analyst I will also assist management with design issues, running reports for the Population Health Outcomes Department and any other technical problem solving.

 

Responsibilities

  • Provide system administration support to the HEDIS application used for NCQA reporting.
  • Build and analyze weekly Quality dashboards demonstrating progression of HEDIS rates
  • Make recommendations to Management as it pertains to HEDIS trends
  • Monitoring the completeness and accuracy of data collected and compiled in the databases and assist Quality Project Manager with regular progress reports for staff.
  • Work with the Quality Project Manager to generate the HEDIS Roadmap. Participates in implementation of performance improvement activities, including HEDIS projects, as assigned; assists with the design and development of healthcare data retrieval tools, flow charts and review processes for HEDIS and other quality improvement monitoring activities.
  • Generate reports weekly, or as needed, for the member engagement reps in the department
  • Understands the different data sources and their inter-relationships; develops the capability to use multiple sources of information to locate member charts and information for various quality improvement initiatives
  • Assist QA Team with training staff on the HEDIS application and tools.
  • Performs other related duties as assigned.

Qualifications

MINIMUM EDUCATION/ EXPERIENCE REQUIREMENTS

 

  • BA/BS degree in Computer Science or Information Systems
  • Minimum 1 year HEDIS reporting or experience in a managed care setting preferred

SPECIAL KNOWLEDGE AND/OR SKILLS

  • Proficient knowledge of Microsoft Office products
  • Windows Operating Systems: XP, Windows 7 & Windows Server 2003 and 2008.
  • Skill in effectively managing and prioritizing multiple projects and tasks to meet deadlines.
  • Skill in resolving internal and external complaints and concerns.
  • Ability to analyze and understand flow diagrams as it relates to HEDIS data retrieval
  • Experience with data analysis and reporting, and performance improvement methodology
  • Effective interpersonal skills characterized by diplomacy to foster effective collaboration and cooperation with internal and external customers

PREFERRED BACKGROUND/EXPERIENCE

  • Project Management skills
  • Familiarity with key managed care functions including Quality, Member Enrollment, Medical Management.
  • Understanding of Health Care Industry; knowledge and understanding of Protected Health Information (PHI) 

PHYSICAL REQUIREMENTS

  • Physical health sufficient to meet the ergonomic standards and demands of the position.

About Us

Virginia Premier Health Plan, Inc. is a managed care organization which began as a full-service Medicaid MCO in 1995. Partnered with VCU Medical Systems we strive to meet the needs of the underserved and vulnerable populations in Virginia by delivering quality driven, culturally sensitive and financially viable Medicare and Medicaid healthcare programs.  Headquartered in Richmond, VA we also have offices in Roanoke, Tidewater and Bristol with additional satellite locations allowing us to serve over 200,000 members across eighty counties throughout Virginia. 

 

We offer competitive salaries and a comprehensive benefits package to include excellent Medical, Dental and Vision Plans, Tuition Assistance, Infant-At-Work Program, Remote Work options and generous vacation and sick leave policies. Our culture supports an environment where employees can continuously learn and gain professional growth through various development programs, education, exciting projects and career mobility.  

 

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or protected veteran status. EOE

 

Our mission is to inspire healthy living within the communities we serve!

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