HEDIS Program Manager
Richmond VA 23233
Job DescriptionThe HEDIS Program Manager develops and implements internal program(s) and member-facing initiatives geared toward increasing HEDIS (Healthcare Effectiveness Data and Information Set) rates and member satisfaction. Collaborates with care management, network, customer care and other internal health plan stakeholders. Works with external quality vendors driving HEDIS activities.
- Provides internal project management, leadership and facilitation of HEDIS related activities.
- Ensures engagement of new and existing vendors for HEDIS related initiatives.
- Provides assessment in partnership with care management, network, customer service and other internal teams of current programs and processes to better integrate HEDIS touch points that drive care gap closure.
- Reviews literature to inform effective approaches in population health.
- Develops documentation related to the design and implementation of HEDIS interventions, including, but not limited to telephone scripts, letters and mailers, program process flows, and state required forms for approval of events.
- Develops and completes reports on intervention and program outcomes.
General Job Information
TitleHEDIS Program Manager
Job FamilyQuality Group
CountryUnited States of America
FLSA StatusUnited States of America (Exempt)
Recruiting Start Date7/31/2019
Date Requisition Created7/30/2019
Work ExperienceNetwork, Project/Program Management
EducationBachelors (Required), Masters: Health Administration, Masters: Nursing
License and Certifications - Required
License and Certifications - Preferred
Other Job Requirements
- Working knowledge of HEDIS.
- Development and/or implementation of interventions and programs to support HEDIS quality improvement.
- Experience working in a managed care health plan and experience working in a Medicaid managed health plan.
- Demonstrated project management skills.
- Strong written and verbal communication skills.
- Ability to work effectively in a virtual work environment.
- Ability to multi-task and work in a matrixed work environment.
- Experience with NCQA accreditation standards and processes
- Behavioral health experience
Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled. Every employee must understand, comply and attest to the security responsibilities and security controls unique to their position.
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