Enterprise HEDIS Data Analyst III

Job Summary:

The Enterprise HEDIS Data Analyst III is primarily responsible for all HEDIS data submissions to state and federal agencies on a timely basis, ensuring the quality of the data submitted meets, at a minimum, the various regulatory requirements.

Essential Functions:

• Work with the Application Development team to ensure the accuracy of programs used to create HEDIS data submissions and that these programs are kept updated for the latest requirements (both CareSource requirements and regulatory)
• Monitor and devise action plans to address HEDIS data that is rejected by agencies
• Work with Quality Improvement, Claims and other operational business owners to ensure accuracy of HEDIS data
•  Work with Quality Improvement, Claims and other operational business owners to ensure appropriate actions take place to address rejections as well as ensure reprocessing of previously rejected data
• Ensure HEDIS data is submitted both timely and accurately to ODJFS, MDCH, the SNP Regulatory Compliance Officer or any other governing body
• Proactively seek out opportunities to improve processes related to regulatory or required data submissions
• Perform any other job related instructions, as requested

Education and Experience:

• Bachelor’s Degree or equivalent years of relevant work experience required
• Healthcare experience required
• Minimum of three (3) years of experience working with data and/or performing analysis using data and analytic tools

Competencies, Knowledge and Skills:

• Advanced Excel and/or Microsoft Access experience required
• HEDIS and/or performance measure experience required
• Experience in the management of a large data project including responsibility for meeting deadlines, accuracy requirements and reporting to upper management required
• Relational database modeling concepts and practices strongly preferred
• Knowledge of structured query language strongly preferred
• SAS and/or SQL Server programming experience preferred
• Excellent customer service skills
• Communication skills both written and verbal
• Ability to work independently and within a team environment
• Critical listening and thinking skills
• Decision making/problem solving skills

Licensure and Certification:

• None

Working Conditions:

• General office environment; may be required to sit or stand for extended periods of time

Compensation Range:

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):

Organization Level Competencies

• Create an Inclusive Environment

• Cultivate Partnerships

• Develop Self and Others

• Drive Execution

• Influence Others

• Pursue Personal Excellence

• 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.