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Manager, HEDIS Operations

Company: Centene Coproration
Location: Baton Rouge
Posted on: August 24, 2019

Job Description:

Description: Position Purpose: Oversee and ensure HEDIS data accuracy and reporting, including investigations, auditing, and improvement opportunities. Collaborate with internal and external stakeholders to ensure HEDIS and CAHPS initiatives are fully integrated throughout the organization, maximizing opportunity to improve outcomes for members. Oversee activities, resources, methods, and procedures to achieve improvement in HEDIS measures Formulate and ensure compliance with HEDIS technical specifications, policies, operating procedures, and goals in compliance with internal and external guidelines Provide comprehensive analysis of HEDIS measures, barriers, and opportunities and present results of improvement efforts and ongoing performance measures to senior management Manage all clinical quality metrics and HEDIS processes and results Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities Oversee all HEDIS projects to include assignment of nurses, adherence to plan timelines, and vendor oversight for timeliness and quality Ensure compliance for all quality audits and maintain all data and process controls

Keywords: Centene Coproration, Alexandria , Manager, HEDIS Operations, Executive , Baton Rouge, Louisiana

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