Manager, HEDIS Operations

This is a fully remote position, open to applicants in United States.

📋 Description

• Convert business requirements into detailed specifications for reports and dashboards.

• Create and publish tailored dashboards for various business functions, stakeholders, and corporate users.

• Design, model, develop, and enhance stored procedures for effective data management and reporting.

• Assist in the collection, abstraction, and reporting of HEDIS data.

• Analyze and implement NCQA HEDIS technical specifications and measurement criteria.

• Monitor, track, analyze, and report on HEDIS performance metrics.

• Develop, sustain, and refine HEDIS/STAR workflows and processes.

• Oversee data quality, validate measurement logic, and prepare metrics for reporting and audits.

• Coordinate comprehensive HEDIS processes, including chart chase, abstraction, and vendor oversight.

• Collaborate with clinical and operational teams, vendors, and systems to ensure data integrity and completeness.

• Track performance trends and identify opportunities for compliance improvement.

• Support comprehensive HEDIS audit activities, including documentation and artifacts.

• Create functional and technical design documentation and maintain records for reports and dashboards.

• Enhance team workflows, establish development practices, and monitor project progress through agile stand-ups and planning sessions.

• Maintain documentation and team standards for tools and processes.

⛳️ Requirements

• A minimum of 6 years of experience in business intelligence and reporting.

• At least 6 years of experience with BI/reporting software products (MSBI) and standards/requirements in the healthcare industry.

• More than 6 years of robust data interpretation and analytical skills.

• Over 3 years of experience in developing HEDIS/STAR workflows and processes.

• Proficient in SQL.

• Experience with Power BI and SSRS (Paginated Reports).

• Familiarity with EDI, HL7, and custom file formats.

• Extensive practical experience with Power BI, SSRS, SSAS, Azure Data Factory, and cloud-based BI/reporting services.

• Experience with Big Data and Azure Data Platform is advantageous.

• Familiarity with Azure, AWS, or GCP is a plus.

• Bachelor's degree in Computer Science, IT, or a related field, or equivalent experience.

• Microsoft Azure Certification is a plus.

• Strategic and analytical thinking skills to derive insights from data.

• Strong organizational and project management capabilities.

• Knowledge of best practices in data governance and quality.

🏝️ Benefits

• Significant opportunities for growth and innovation.

• Reasonable accommodations for individuals with disabilities.

• Commitment to Equal Employment Opportunity and Affirmative Action.