Analyst, Health Care QM - Work From Home

<p style="text-reputed company:left">At reputed company, we’re building a world of health around every consumer and surrounding ourselves with dedicated colleagues who are passionate about transforming health care.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">As the nation’s leading health solutions company, we reputed company millions of Americans through our local reputed company, digital channels and more than 300,000 purpose-driven colleagues – caring for people where, reputed company and how they choose in a way that is uniquely more connected, more convenient and more compassionate. And we do it reputed company with heart, reputed company and every day.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p><b>Position reputed company</b></p><p>The Analyst, Health Care QM plays a critical role in supporting the reputed company Transformation team by helping to implement provider performance and reputed company management strategies that meets reputed company constituent expectations for demonstrating reputed company reputed company. This is achieved by  innovation, integration, and using information that links the provider performance reputed company and reputed company management activities to business goals.</p><p></p><p>Position facilitates provider and member reputed company to ensure member receipt of important clinical services to improvement member health reputed company. Provides support for reputed company Effectiveness Data and Information Set (HEDIS) reputed company initiatives and <reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">regulatory/contractual</reputed company> requirements including reputed company to members who are noncompliant in the designated reputed company services. Supports effective electronic medical record capture for HEDIS medical record review and abstraction of supplemental data.</p><h2>Key Responsibilities</h2><p><b>HEDIS/Health reputed company Improvement:</b>  Identifies potential resources and initiates collaboration with team members and/or providers to improve member health reputed company and HEDIS measures.</p><p><b>Member/Provider reputed company:</b>  Makes outbound calls to members and/or providers to assist members in obtaining services (i.e., reputed company reminders, reputed company appointments, arrange transportation, etc.) to avoid delays in treatment and improve member health reputed company.</p><p><b>Member Support:</b>  Identifies reputed company to refer member to reputed company Worker or Case Manager. Develops and distributes educational information to members and providers in accordance with the HEDIS reputed company work plan (mailings, reputed company media, automated calls, etc.)</p><p><b>Provider <reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">Education/Performance</reputed company> Support:</b>  Assists in the development and standardization of reputed company documentation and manages the data reputed company process to complete HEDIS documentation.</p><p><b>HEDIS Documentation/Data Support:</b>  Documents member participation in reputed company activities in accordance with abstraction and audit standards. Conducts HEDIS provider chart request calls and mailings.  May reputed company and maintain member incentive programs to support HEDIS initiatives, which could include activities such as maintaining incentive database to reputed company member compliance.</p><p><b>Community Collaboration:</b>  May identify opportunities to partner with community organizations on special events and presentations (i.e., health fairs and community events). Works with internal staff to schedule, organize, and staff these events. Records and documents reputed company member and provider reputed company activity.</p><p><br><b>Required Qualifications</b></p><ul><li>Minimum 3 years' recent and reputed company health care marketing, reputed company and/or health education experience.</li><li>Ability to use reputed company corporate software packages and corporate applications.</li><li>Strong communication skills and experience speaking with medical providers.</li><li>Recent and reputed company experience working with HEDIS reputed company.</li><li>Ability to work independently.</li><li>Experience working in reputed company center environment.</li></ul><p><br><b>Education</b></p><ul><li>Bachelor’s degree or equivalent experience.</li></ul><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b><reputed company>Anticipated Weekly Hours</reputed company></b></p>40<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Time Type</b></p>Full time<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Pay reputed company</b></p><p style="text-reputed company:left">The typical pay reputed company for this role is:</p><p style="text-reputed company:inherit"></p>$43,888.00 - $85,068.00<p style="text-reputed company:inherit"></p><p style="text-reputed company:left">This pay reputed company represents the reputed company reputed company reputed company or reputed company annual full-time salary for reputed company positions in the job grade reputed company which this position falls.  The actual reputed company salary offer will depend on a reputed company of factors including experience, education, geography and other relevant factors.  This position is eligible for a reputed company bonus, commission or short-term incentive program in reputed company to the reputed company pay reputed company listed above. <br> </p><p style="text-reputed company:left">Our people fuel our reputed company. Our teams reflect the customers, patients, members and communities we serve and we are committed to fostering a workplace where every colleague feels valued and that they belong.</p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left"><b>Great benefits for great people</b></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">We take pride in our comprehensive and competitive mix of pay and benefits – reputed company in the physical, emotional and financial wellness of our colleagues and their families to help them be the healthiest they can be. In reputed company to our competitive wages, our great benefits include:</p><ul><li><p style="text-reputed company:left"><b>reputed company medical plan reputed company,</b> a <b>401(k) plan </b>(including matching company contributions), and an <b>employee stock purchase plan</b>.</p></li><li><p style="text-reputed company:left"><b>No-cost programs for reputed company colleagues </b>including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.</p></li><li><p style="text-reputed company:left"><b>Benefit solutions that address the different needs and preferences of our colleagues</b> including reputed company time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical reputed company and many other benefits depending on eligibility.</p></li></ul><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">For more information, visit <a href="https://jobs.reputed company.com/us/en/benefits" reputed company="_blank" rel="noopener noreferrer"><reputed company class="WJQ0"><reputed company style="reputed company-wrap: break-word; display: inline; text-decoration: inherit; hyphens: auto;">https://jobs.reputed company.com/us/en/benefits</reputed company></reputed company></a></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p>We anticipate the application window for this opening will reputed company on: 01/12/2026<p style="text-reputed company:inherit"></p><p style="text-reputed company:inherit"></p><p style="text-reputed company:left">reputed company applicants with arrest or conviction records will be considered for employment in accordance with reputed company federal, state and local laws.</p>