HEDIS Reporting Analyst (Remote)

LOCATION: Remote – this is a home based, virtual position that operates Monday – Friday from 8:30am-5:00pm (EST). Vaya Health welcomes applications from NC, SC, GA, TN, VA, MD, and FL.

GENERAL STATEMENT OF JOB

This position performs data collection, analysis, and reporting for all Vaya Health (Vaya) Healthcare Effectiveness Data and Information Set (HEDIS) performance measures, ensuring accurate reporting of quality performance metrics, and identifying areas for improvement within Vaya. The reporting requirements supported by this position are required by the NC Department of Health and Human Services (NCDHHS) as well as applicable oversight and accrediting agencies. This position supports quality improvement data analytics and data governance, in accordance with the requirements outlined in Vaya Health’s Quality Management Annual Plan and related documents.

ESSENTIAL JOB FUNCTIONS

HEDIS Reporting Analyst Responsibilities:

• Collaborate and work closely with Vaya staff cross-functionally, including but not limited to the Information Services Division, Quality Management Department, and Population Health Division, to review and monitor HEDIS performance measures and results as required by NCDHHS and oversight/ accrediting bodies.
• Assess performance against industry benchmarks and NCDHHS standards; including effectiveness of care, access/availability of care, experience of care, utilization, and health plan descriptive information.
• Assist with data collection, analysis, interpretation and reporting of quality improvement activities and projects.
• Analyze HEDIS data to identify trends, anomalies, and potential improvement opportunities.
• Develop and present results, findings, and recommendations regarding HEDIS performance measures to both internal and external stakeholders.
• Develop and maintain reports that provide insights into clinical processes, workflows and outcomes, facilitating informed decision-making.
• Maintain detailed documentation of operational processes and report specifications.
• Implement quality management principles, theories, and tools to facilitate process improvements.
• Evaluate and understand the policies, procedures, and constraints of clinical or business operations related to reporting requirements.
• Develop or adapt process and outcome measures in support of quality improvement goals.
• Research performance measurement outliers.
• Assess the relevance, integrity, and accuracy of data sources, including claims, electronic health data, and electronic health records.
• Analyze and troubleshoot complex data errors and problems.
• Support and serve as a technical liaison for the Quality Improvement Committee.
• Assist with ad hoc requests for data reporting and data analysis.
• Other duties as assigned.

KNOWLEDGE, SKILLS, & ABILITIES

Required:

• Experience analyzing NCQA and HEDIS measures.
• Strong project management and administration background with the ability to work with organization leadership to present data and results.
• Ability to develop organizational performance reports according to standard templates.
• Ability to analyze data to identify root causes and develop an approach for responding.
• Ability to complete tasks in a timely and accurate manner.
• Excellent time management skills and the ability to manage competing priorities and projects.
• Strong organizational skills with attention to detail and the ability to multi-task.
• Ability to work independently with little or no direction, demonstrate initiative, be goal-oriented, and function as a self-starter.
• Ability to problem solve and provide practical, thorough and creative solutions to work tasks.
• Ability to learn, interpret independently, and apply a variety of complex policies and procedures.
• Highly effective oral and written communication skills, including strong presentation skills and proficiency in grammar, punctuation, and spelling.
• Exceptional interpersonal skills, diplomacy and conflict resolution skills.
• Extensive knowledge and advanced proficiency in Adobe and Microsoft Office products (Word, Excel, Outlook, PowerPoint, Visio, etc.), including experience with pivot tables, graphs, charts, etc.
• Demonstrate strong attention to detail, extreme precision, and meticulous accuracy for all tasks.

Preferred:

• Strong knowledge of state and federal rules, requirements and practices related to Vaya Health’s operations in North Carolina.

EDUCATION & EXPERIENCE REQUIREMENTS

Associate degree in Human services, finance, business administration, computer science or related fields. Bachelor’s degree preferred.

Must have:

• Four years of experience analyzing HEDIS measures as a business, data, or performance analyst.

PHYSICAL REQUIREMENTS

Close visual acuity to perform activities such as preparation and analysis of documents; viewing a computer terminal; and extensive reading.

Physical activity in this position includes crouching, reaching, walking, talking, hearing and repetitive motion of hands, wrists, and fingers.

Sedentary work with lifting requirements up to 10 pounds, sitting for extended periods of time.

Mental concentration is required in all aspects of work.

RESIDENCY REQUIREMENT:

The person in this position must reside in NC, SC, GA, TN, VA, MD, or FL.

SALARY:

Depending on qualifications & experience of candidate. This position is exempt and is not eligible for overtime compensation.

DEADLINE FOR APPLICATION:

Open Until Filled

Vaya Health is an equal opportunity employer.