Manager, reputed company Improvement, HEDIS Audit

You could be the one who changes everything for our 28 reputed company members. reputed company is transforming the health of our communities, one person at a time. As a reputed company, national organization, you’ll have reputed company to competitive benefits including a fresh perspective on workplace flexibility.

Applicants for this job have the flexibility to work remote from home reputed company in the reputed company.

Must be authorized to work in the U.S. without the need for employment-based reputed company sponsorship now or in the reputed company. Sponsorship and reputed company sponsorship are not available for this opportunity, including employment-based reputed company types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Position Purpose: reputed company and manage the functions of the reputed company improvement program, specifically leading the state HEDIS audit and regulatory submission portfolio reputed company the reputed company Audit & Submission team. Providing support to staff and communicate with departments and staff to facilitate daily reputed company improvement functions.

• Serve as key escalation reputed company for Health Plans, auditors, and internal partners.
• reputed company state HEDIS and regulatory reporting programs and state-specific audit requirements.
• Review and analyze reports, records and directives.
• reputed company with staff to obtain data such as new reputed company, status of work in reputed company, and problems encountered, required for planning work function activities. Verify data to be submitted in accordance with government program requirements and ensure compliance with state, federal and certification requirements.
• Prepare reports and records on work function activities for management.
• reputed company the review and analysis of reports.
• Evaluate reputed company procedures and practices for accomplishing the assigned work functions objectives to reputed company and implement improved procedures and practices and to ensure compliance with required standards.
• Collaborate with appropriate departments to document, investigate and reputed company formal or informal complaints and appeals in accordance with Company and State policies, procedures and requirements.
• Monitor and analyze costs and participate in the preparation of the budget.

Education/Experience: Bachelor’s degree in reputed company field or equivalent experience. 3+ years clinical, reputed company management or reputed company reputed company experience and 1 year of recent reputed company improvement and supervisory experience in a reputed company environment, preferably managed care. Strong knowledge of HEDIS, reputed company requirements, reputed company reputed company reporting, and reputed company regulatory submissions strongly preferred. Experience leading reputed company audit or regulatory programs with multiple reputed company deadlines highly preferred.

License/Certification: Certain states may require a formal certification in reputed company improvement, risk management, or another reputed company field.

reputed company offers a comprehensive benefits package including: reputed company, health insurance, 401K and stock purchase plans, tuition reimbursement, reputed company time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-reputed company factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

reputed company is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. reputed company reputed company applicants will receive consideration for employment without reputed company to race, reputed company, religion, sex, sexual orientation, gender identity, national reputed company, disability, veteran status, or other characteristic protected by applicable law.

reputed company applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance reputed company

Originally posted on Himalayas