Sorry, this job is no longer accepting applications. See below for more jobs that match what you’re looking for!

VP Hedis Strategy

Expired Job

Amerihealth Caritas Health Plan Philadelphia , PA 19107

Posted 5 months ago

Position Summary:

Reporting to, the Senior Vice President, Medical Excellence and Clinical Solutions, the Vice President, HEDIS serves as the business owner responsible for leading the cross functional team efforts for STARS / HEDIS Optimization. This person will identify opportunities for next best actions to close health care gaps, improve quality of care and lower costs. The candidate will apply expertise in developing and utilizing key performance indicators to identify and investigate complex problems in various health care domains across several problem spaces. This position will deliver results on high-impact projects collaborating with Informatics to support data driven decision making.

This person will need to perform in a fast-paced environment, will have an operational mindset with attention to detail, and will focus on identifying value to challenging business problems. This position requires someone with strong business acumen, It is critical to have exceptional communication skills and the ability to make complex concepts simple and easy to understand. This candidate will utilize techniques from many fields including statistics, data mining, visualization, and predictive analytics.

Major Accountabilities:

  • Accountable for driving business strategy through the use of data and clinical intelligence.

  • Collaborates closely with Informatics team, IS and other key functional areas to develop a HEDIS, STARS strategy that utilizes data and analytics to drive execution and performance.

  • Oversees the development of proactive HEDIS / STARS strategies and defines processes to review and optimize interventions / initiatives to deliver excellent results of STARS and HEDIS.

  • Oversees and develops analytics models in collaboration with Informatics team to support HEDIS /STARS strategies to ensure high quality scores.

  • Oversees HEDIS abstraction team and ensures excellent results on quality scores.

  • Represents the business in developing data analytics for research operations and reporting and ensures data is presented for end-user consumption.

  • Oversees the development of proactive HEDIS / STARS strategies and defines processes to review and optimize interventions / initiatives.

  • Oversees the Identification and implementation of best practices for HEDIS / accreditation.

  • Ensures training and auditing activities support HEDIS abstraction and analytics.

  • Leads evaluation and identification of new capabilities and develops recommendations for "build vs. buy" decisions.

  • Collaborates with population health team in coordinating activities with provider network team.

Experience and Education:

  • Ten or more years Healthcare Leadership/Management; Clinical Program Development; Medicaid/Managed Care Experience, QUALITY and HEDIS

  • Ability to manage large scale projects simultaneously.

  • Ability to influence senior level executives.

  • This position requires someone with proven strong business acumen, coupled with the ability to communicate findings to both business and IT leaders in a way that can influence how the organization approaches a business challenge.

  • Masters degree required or equivalent experience

See if you are a match!

See how well your resume matches up to this job - upload your resume now.

Find your dream job anywhere
with the LiveCareer app.
Download the
LiveCareer app and find
your dream job anywhere

Boost your job search productivity with our
free Chrome Extension!

lc_apply_tool GET EXTENSION

Similar Jobs

Want to see jobs matched to your resume? Upload One Now! Remove
Hedis Analyst

Amerihealth Caritas Health Plan

Posted 1 week ago

VIEW JOBS 12/6/2018 12:00:00 AM 2019-03-06T00:00 Supports corporate, plan-level, and departmental strategies and goals for HEDIS process. Meets this standard by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems. Essential Functions include but not limited: * Manage the HEDIS lifecycle process for multiple plans. * Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations. * In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs. * Assist in preparation for the HEDIS audit. * Develop and maintain HEDIS based report to support Quality Initiatives. * Represent HEDIS team in collaboration with internal departments for HEDIS improvement. * Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline. * Assists as necessary in the HEDIS Road Map and all other documents required by auditors. * Able to assimilate into team within minimum amount of assistance * Assures the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers. * Experience and ability to utilize a certified HEDIS software. Education & Experience: * Bachelor's degree required with a concentration in health care related field, Master's degree is preferred * Minimum 1 year HEDIS experience required; 2+ years' experience with HEDIS preferred. * Minimum 5 years of work experience in healthcare and/or managed care * Other skills:SQL and / or SAS experience required * Opportunity to work remotely commensurate to HEDIS experience Amerihealth Caritas Health Plan Philadelphia PA

VP Hedis Strategy

Expired Job

Amerihealth Caritas Health Plan