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HEDIS Data Reporting Specialist
Supv LocationLEE'S SUMMIT
Posting Closes
SupervisorLaura Connolly
Job Code136210
DepartmentCARE MANAGEMENT
  
Job Responsibilities

GEHA is an Equal Opportunity Employer with five locations in the Kansas City metropolitan area. Our company's corporate headquarters is located in Lee's Summit near Douglas Rd and I-470. The claims processing office and call center is located in Independence near Little Blue Parkway and I-70. All offices are easily accessible by freeway from anywhere in the Kansas City metro area.

Open Positions: 1
Location: Lee’s Summit, MO (200 Building)

Summary

Primarily responsible for data management and analysis. Coordinates with HEDIS analyst on data reporting including data pulls from queries specific to HEDIS. Responsible for communicating results and gap reporting support for clinical HEDIS staff. Analyzes HEDIS data and makes recommendations to manager. Serves as support for clinical staff for HEDIS data system. Educates staff in the use of HEDIS data and the quality improvement process. Assists with OPM, OIG, and internal audits. Performs member medical records audits as needed. Coordinates with Information Services department and other internal departments to resolve data issues surrounding data pulls from HEDIS canned reports.

Duties

• Coordinates with HEDIS analyst on data reporting including data pulls from queries specific to HEDIS. Responsible for communicating results and gap reporting support for clinical HEDIS staff. Analyzes HEDIS data and makes recommendations to manager.

• Serves as support for clinical staff for HEDIS data system. Attends meetings, creates agendas and documents meeting minutes. Ensures agenda and minutes are saved on the shared drive. Notifies CMD leadership of escalated issues.

• Manages multiple projects by effectively prioritizing work and communicating workload issue to manager.

• Serves as an educator in the use of HEDIS data and the quality improvement process.

• Manages medical record retrieval (MRR) storage and tracking. Supports clinical staff as needed. Track MRR vendor performance and provides outcomes to HEDIS analyst and manager.

• Manage off season non-standard supplemental data entry and storage.

• Serves as the HEDIS data liaison between Care Management and other internal parties who play a role in the program delivery. Schedules meetings with appropriate audiences to resolve program issues in a timely manner.

• Assists with OPM, OIG, and internal and external audits applicable to the HEDIS program by providing needed workflows, documents, and other program information.

• Performs member medical records audits to ensure services were provided.

• Coordinates with Information Services departments and other internal departments to resolve data issues surrounding data pulls from HEDIS standardized reports.

• Validates the structural integrity of manual and electronic data sets.

Education Requirements
Bachelor’s Degree in relevant area or equivalent work experience.

Experience Requirements
Requires three years of HEDIS experience including experience analyzing large data sets in a health insurance or health care setting. Requires analytical skills to evaluate and interpret data and must be capable of making independent decisions. Requires effective verbal and written communication skills to compose formal documents, present ideas and communicate with staff and all levels of GEHA management. Requires knowledge of MS Excel applications, particularly Access and Project. SQL skills required.