Job Summary:
The Manager, Enterprise HEDIS Analytics is responsible for managing the creation, scoping, planning, prioritizing, and managing of HEDIS analytic team. This includes working with key business owners to establish and meet their HEDIS analytic needs or the HEDIS analytic needs of the organization
Essential Functions:
- Serve as HEDIS consultant for members of the CareSource management team
- Responsible for the execution of the efforts conducted by the HEDIS Analytics team as they conduct in-depth analysis such as provider practice patterns, examination of complex data relationships, and use of statistical techniques to measure impact of various actions/results
- Serve as a DSI management liaison on HEDIS analytic needs of the organization including HEDIS related workgroups and committees.
- Assist in the evaluation of appropriate predictive solutions that would benefit HEDIS efforts of the organization
- Execute the various outcome/analytic efforts that establish CareSource as a leader in HEDIS analytics. These efforts would identify trends and variances and identify in-depth cause-effect relationship between seemingly unrelated components, culminating in some public publication and/or presentation of the findings
- Working with the Director, Healthcare Analytics, drive the creation of unique graphics that effectively describe, explore and summarize HEDIS analysis for communication to appropriate parties
- Perform any other job duties as requested
Education and Experience:
- Bachelor of Science/Arts degree in Management Information Systems (MIS), computer science or related field or equivalent work experience is required
- Master of Public Health (MPH), Business Administration (MBA), or related field is preferred
- HEDIS or similar healthcare performance metrics experience required
- Seven (7) or more years of experience in data analysis is required
- Three (3) or more years of experience with healthcare delivery and/or healthcare payer organizations is required
- One (1) of more years of experience in leading analytic teams is required
- Clinical experience is preferred
- Proven understanding of 3rd or 4th generation languages with emphasis on delivery of analytics to the business
- SAS experience strongly preferred
- Training in statistics and/or statistical process control methodology preferred
Competencies, Knowledge and Skills:
- Graphic development/presentation skills
- Exceptional Excel skills
- Exceptional analytical, problem solving and critical thinking skills
- Strong service orientation and consulting skills
- Proven ability to work collaboratively with all levels of management
- Ability to lead mission-critical, high visibility projects
- Proven ability to juggle multiple complex priorities within a changing environment
- Highly developed communications skills (both written and verbal)
- Knowledge of health care coding including CPT-4, HCPCS, ICD-9, DRG and Revenue Codes strongly preferred
Licensure and Certification:
- None
Working Conditions:
- General office environment; may be required to sit or stand for extended periods of time
Compensation Range:
$79,800.00 - $127,600.00
CareSource takes into consideration a combination of a candidate’s education, training, and experience as well as the position’s scope and complexity, the discretion and latitude required for the role, and other external and internal data when establishing a salary level. We are highly invested in every employee’s total well-being and offer a substantial and comprehensive total rewards package.
Compensation Type (hourly/salary):
Salary
Organization Level Competencies
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Create an Inclusive Environment
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Cultivate Partnerships
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Develop Self and Others
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Drive Execution
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Influence Others
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Pursue Personal Excellence
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Understand the Business
This job description is not all inclusive. CareSource reserves the right to amend this job description at any time. CareSource is an Equal Opportunity Employer. We are dedicated to fostering an inclusive environment that welcomes and supports individuals of all backgrounds.
Top Skills
What We Do
Health Care with Heart. It is more than a tagline; it’s how we do business. CareSource has been providing life-changing health care to people and communities for nearly 30 years and we will continue to be a transformative force in the industry by placing people over profits.
CareSource is and will always be members first. Even as we grow, we remember the reason we are here – to make a difference in our members’ lives by improving their health and well-being. Today, CareSource offers a lifetime of health coverage to nearly 2 million members through plan offerings including Marketplace, Medicare Advantage and Medicaid. With our team of 4,000 employees located across the country, we continue to clear a path to better life for our members. Visit the "Life" section to see how we are living our mission in the states we serve.
CareSource is an equal opportunity employer and gives consideration for employment to qualified applicants without regard to race, color, religion, sex, age, national origin, disability, sexual orientation, gender identity, genetic information, protected veteran status or any other characteristic protected by applicable federal, state or local law. If you’d like more information about your EEO rights as an applicant under the law, please click here: https://www.eeoc.gov/employers/upload/poster_screen_reader_optimized.pdf and here: https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP_EEO_Supplement_Final_JRF_QA_508c.pdf
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