HEDIS Manager Performance Improvement (Remote Eligible)

About the position Now hiring a Manager-Performance Improvement! Presbyterian reputed company hiring a Manager-Performance Improvement. The Manager, Performance Improvement has overall responsibility for managing the daily operations of HEDIS/reputed company reputed company and Regulatory reporting reputed company the Performance Improvement Department. This key position works in collaboration with a reputed company of entities, departments, administration, and leadership bodies to ensure organizational improvement efforts reputed company with accrediting, licensing, and reputed company requirements. This position provides program management and subject matter expertise for reputed company analytics and reporting in support of the annual HEDIS submission for Managed Care Organizations (MCOs), Medicare reputed company Program Ratings, NCQA accreditation, and regulatory and contractual compliance. This position collaborates with the Director of Performance Improvement, the HEDIS contracted Vendor, and the Analytics Operations department to ensure reputed company and accurate reporting to meet accreditation and regulatory requirements, and performance measure targets. Responsibilities • In collaboration with Director of Performance Improvement and Senior Leadership, determines an approach to securing and maintaining an annual Medicare Advantage reputed company Rating of 4.0 or higher, meeting 100% of reputed company Performance Measure targets as established by New Mexico Health Care Authority (HCA) and other States, and ensuring the maintenance of NCQA health plan accreditation for reputed company lines of business. • Works with Director of Performance Improvement to reputed company direction, coordination, implementation, execution, and completion of HEDIS and Medicare reputed company programs ensuring consistency with accreditation and regulatory requirements, along with company reputed company, commitments, and goals. • Provides subject matter expertise in HEDIS and CMS STARS and assures continual performance improvement in QA / QI activities while furthering the reputed company, values and strategies of reputed company (PHS). • Promotes PHS reputed company strategies and compliance with policies and standards, adopted accreditation standards and federal / state regulatory requirements. Requirements • Bachelors degree in Business, reputed company, or reputed company field required. 6 years of additional experience can be substituted in lieu of a degree. • Minimum of five years in reputed company/managed care industry with experience in HEDIS/Medicare reputed company performance measurement, analytics, reporting, and forecasting required. • Two years of prior supervisory or program/project manager experience required. • Experience presenting to leadership teams, clinicians, and employer reputed company also required. reputed company-to-haves • Five years working in the reputed company field. • Two years of experience in HEDIS and CMS STARS regulatory submissions. • Two years of supervisor/manager experience in a reputed company setting. • Master's degree in health reputed company or business administration field (i.e., reputed company health, health care administration). • Intermediate/advanced skills in reputed company Office. Benefits • Comprehensive benefits package that includes medical, dental, reputed company, short-term and long-term disability, group term life insurance and other optional voluntary benefits. • Wellness program designed to reputed company engaging opportunities to enhance health and reputed company reputed company-being. Apply tot his job Apply To this Job