HEDIS Analyst

For roles that are 100% remote or hybrid, you must have access to a reliable high-speed internet connection to support daily job responsibilities. A minimum bandwidth of 50 Mbps download and 5 Mbps upload is required. Those fully remote associates residing in states where service is required by contract, law, or regulation will be allowed to submit for reimbursement.

Your career starts now. We are looking for the next generation of health care leaders.

At AmeriHealth Caritas, we are passionate about helping people get care, stay well and build healthy communities. As one of the nations leaders in health care solutions, we offer our associates the opportunity to impact the lives of millions of people through our national footprint of products, services and award-winning programs. AmeriHealth Caritas is seeking talented, passionate individuals to join our team. Together we can build healthier communities. If you want to make a difference, we would like to hear you.

Headquartered in Newtown Square, AmeriHealth Caritas is a mission-driven organization with more than 30 years of experience. We deliver comprehensive, outcomes-driven care to those who need it most. We offer integrated managed care products, pharmaceutical benefit management and specialty pharmacy services, behavioral health services, and other administrative services.

Discover more about us at www.amerihealthcaritas.com.

Role Overview:

The HEDIS Analyst supports corporate, plan-level, and departmental strategies for the HEDIS process by managing the full lifecycle of HEDIS measures, ensuring data accuracy, and interpreting results into actionable recommendations. This role requires a combination of technical skills, like using HEDIS software and SQL, and business knowledge to support initiatives and solve problems related to healthcare quality metrics. The HEDIS Analyst collaborates with internal departments and external vendors to manage projects, prepare for audits, and produce reports to improve quality ratings.

Work Arrangement

• Remote role.
• Monday through Friday from 8:00a EST to 5:00p EST.

Responsibilities:

• 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 and Experience:

• Bachelor’s Degree preferred with a concentration in health care related field.
• Minimum of 1 year HEDIS experience required.
• Minimum of 5 years of work experience in healthcare and/or managed care.
• SQL experience required.

Our Comprehensive Benefits Package

Flexible work solutions including remote options, hybrid work schedules, Competitive pay, Paid time off including holidays and volunteer events, Health insurance coverage for you and your dependents on Day 1, 401(k) Tuition reimbursement and more.