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HEDIS Lead- Abstraction (PS27954) Remote within the US (EST/CST preferred)Location: United StatesNewRequisition #: PS27954Your Talent. Our Vision. At Anthem, Inc ., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care. This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.The selected candidate will have a strong HEDIS Measure understanding and abstraction/over read experience. The ideal candidate would have a strong background in abstraction and managing temporary staff. They will not have any direct reports but they will manage the temporary staff every year and it is a critical component of what they do. Will be responsible for coordinating, implementing, and executing HEDIS Quality Department specific projects, ensuring consistency with company strategy, commitments, and goals.Primary duties may include, but are not limited to:
Leads annual HEDIS medical record collection, abstraction and research process; synthesizes aggregate plan and product level data medical record data; establishes the baseline and measures the change, data gathering, presentation, and interpretation for optimal HEDIS data/results.
Prepares and maintains project plans and schedules inclusive of tasks, timelines, resources, milestones, dependencies, and assumptions.
Leads teams regarding work flow process improvement, document management, and abstraction education.
Hires, trains, and supervises onsite and offsite temporary staff.
Evaluates and monitors performance and efficiency of programs to ensure that implementation meets targeted timelines.
Collaborates with multiple departments and external vendor to annually field a new HEDIS project.
Requires an AD in healthcare field; 2+ years of experience with HEDIS activity coordination or working with Managed/Acute/Provider Care environment, including 2+ years of analytical experience; or any combination of education and experience, which would provide an equivalent background. BA/BS preferred. RN, RHIA or RHI license preferred. NCQA and HEDIS experience preferred. Project experience required, experience leading projects is preferred. Knowledge and experience interpreting technical specifications for HEDIS measurement related to Medicare, Commercial and Medicaid is preferred.Preferred:
Minimumof 2 years HEDIS Abstraction Experience Preferred
Experienceleading temporary staff and over reading HEDIS abstractions a plus
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2018 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at careers.antheminc.com. An Equal Opportunity Employer/Disability/Veteran.
Vacancy expired!