Expert HEDIS Business Analyst

1 month ago

Houston, Texas, United States Allscripts Full time

Allscripts

Welcome to Veradigm, where our Mission is transforming health, insightfully. Join the Veradigm team and help solve many of todays healthcare challenges being addressed by biopharma, health plans, healthcare providers, health technology partners, and the patients they serve. At Veradigm, our primary focus is on harnessing the power of research, analytics, and artificial intelligence (AI) to develop scalable data-driven solutions that bring significant value to all healthcare stakeholders. Together, we can transform healthcare and enable smarter care for millions of people.

Veradigm Payer

Veradigm understands that managed care organizations, pharmacy benefit managers (PBMs), insurance companies, health plans, and other payers need to balance controlling costs with the goal of providing the highest quality of care and optimizing health outcomes for their members.

Solutions from Veradigm Payers:

  • Deliver insights to drive quality outcomes cost-effectively
  • Improve efficiency for themselves, their providers, and their members through high-speed clinical data exchange
  • Impact point-of-care decision making positively by integrating payer guidance and prior authorization management directly in each healthcare providers existing workflow

Job Summary

The Expert HEDIS Business Analyst will assist our organization as a subject-matter-expert in payer quality measure reporting and analytics, working within a team responsible for the support, maintenance and product strategy for a suite of quality solutions.

Essential Functions

  • Assist with the HEDIS, QRS and STARs support for multiple plans through annual reporting and year-round analytics.
  • Conduct research for customer inquiries specific to HEDIS Submissions process
  • Facilitate customer meetings to deliver research findings or ad hoc reporting
  • Develop business cases and requirements for new products and current product enhancements.
  • Conduct and document UAT for analytics and reporting solutions.
  • Represent Quality team in collaboration with other internal teams for continual process improvement initiatives to simplify and enhance the customer experience.
  • Research and maintain awareness of NCQA and CMS regulatory guidance and changes, providing expert interpretation for impacts to products and customers.
  • Contribute to the mentoring and training of other team members.

Job Requirements

  • Bachelors degree or equivalent combination of education and work experience
  • Minimum 4 years of experience, and strong working knowledge of, analyzing and interpreting HEDIS administrative and hybrid measure data in a vendor or health plan setting.
  • Minimum 4 years of experience actively participating in the HEDIS annual submission process in a vendor or health plan setting.
  • Strong working knowledge of NCQA, CMS and State reporting processes and requirements.
  • Working knowledge of the HEDIS abstraction process from sampling through to final rates
  • Up to 10% travel may be required.

Knowledge, Skills and Abilities

  • Extensive experience in healthcare industry, with a focus on quality reporting and analytics.
  • Advanced knowledge and in-depth understanding of HEDIS, QRS and STARS technical specifications.
  • Experience working with healthcare data analytics.
  • Proven technical, analytical, detail oriented, and problem-solving skills.
  • Strong written and verbal communication skills.
  • Data querying skills, preferably SQL
  • Professional and interpersonal.
  • Self-initiative and leadership.
  • Ability to work within a team environment.
  • Ability to interface with both external and internal personnel at all levels.

Compliance

Job responsibilities include fostering the Companys compliance with all applicable laws and regulations, adherence to the Code of Conduct and Compliance Program requirements, policies and procedures. Compliance is everyones responsibility.

#LI-Remote

Enhancing Lives and Building Careers

Veradigm believes in empowering our associates with the tools and flexibility to bring the best version of themselves to work and to further their professional development. Together, we are In the Network. Interested in learning more?

Take a look at our Culture, Benefits, Early Talent Program, and Additional Openings.

We strongly advocate that our associates receive all CDC recommended vaccinations in prevention of COVID-19.

Visa Sponsorship is not offered for this position.

At Veradigm, our greatest strength comes from bringing together talented people with diverse perspectives to support the needs of healthcare providers, life science companies, health plans, and the patients they serve. The Veradigm Network is a dynamic, open community of solutions, external partners, and cutting-edge artificial intelligence technologies that provide advanced insights, technology, and data-driven solutions. Veradigm offers a comprehensive compensation and benefits package, including holidays, vacation, medical, dental, and vision insurance, company paid life insurance and retirement savings.

Veradigms policy is to provide equal employment opportunity and affirmative action in all of its employment practices without regard to race, color, religion, sex, national origin, ancestry, marital status, protected veteran status, age, individuals with disabilities, sexual orientation or gender identity or expression or any other legally protected category. Applicants for North American based positions with Veradigm must be legally authorized to work in the United States or Canada. Verification of employment eligibility will be required as a condition of hire. Veradigm is proud to be an equal opportunity workplace dedicated to pursuing and hiring a diverse and inclusive workforce.

From a "VEVRAA Federal Contractor" We request Priority Referral of Protected Veterans

This is an official Veradigm Job posting. To avoid identity theft, please only consider applying to jobs posted on our official corporate site.

Thank you for reviewing this Veradigm opportunity.



PI

  • Guidewire Business Analyst

    3 days ago

    Houston, Texas, United States Atlas Cloud Foundry LLC Full time

    Job Title: Guidewire Business AnalystLocation: RemoteVisa: USC OR GC OR GC_EAD ONLYContract Description:Skill setKey Responsibilities:Product backlog grooming and prioritizationWriting user stories and documentation within tools such as JiraGathering and documenting business requirementsGuiding stories through the development processEnd-user training and...

  • Supply Chain Business Analyst

    7 days ago

    Houston, Texas, United States Collabera Full time

    Position: Business Analyst / Supply ChainLocation: RemoteDuration: ContractCompensation: CompetitiveOverview:The Business Analyst will collaborate with various managers across the organization to develop and uphold the Schedule of Value (SOV), Statement of Work (SOW), and Item Master records essential for bidding and awarding materials, as well as...

  • IT Business Analyst

    3 months ago

    Houston, Texas, United States Quaterbackstaffing Full time

    Job Description As an IT Business Analyst you will design develop and implement information systems integrating operational and business data to generate insight and improve finance supply chain and enterprise performance.Job Requirement Minimum 0-2 years of experience as IT Business Analyst or any Non IT baground Demonstrated ability to work well with...

  • Supply Chain Business Analyst

    1 week ago

    Houston, Texas, United States Collabera Full time

    Position: Business Analyst / Supply ChainLocation: HybridDuration: 4 MonthsCompensation: $35-40/hrOverview:The Business Analyst plays a pivotal role in collaborating with management across various business sectors to develop and uphold the Schedule of Value (SOV), Statement of Work (SOW), and Item Master records essential for bidding and awarding materials,...

  • Supply Chain Business Analyst

    7 days ago

    Houston, Texas, United States Collabera Full time

    Position: Business Analyst - Supply ChainLocation: HybridDuration: ContractCompensation: CompetitiveOverview:The Business Analyst plays a crucial role in collaborating with management across various business sectors to develop and uphold the Schedule of Value (SOV), Statement of Work (SOW), and Item Master records essential for bidding and awarding...

  • Supply Chain Business Analyst

    7 days ago

    Houston, Texas, United States Collabera Full time

    Position: Business Analyst / Supply ChainLocation: RemoteDuration: ContractCompensation: Competitive hourly rateOverview:The Business Analyst plays a crucial role in collaborating with management across various business sectors to develop and uphold the Schedule of Value (SOV), Statement of Work (SOW), and Item Master records essential for bidding and...

  • Senior PeopleSoft Business Systems Analyst

    1 week ago

    Houston, Texas, United States MD Anderson Cancer Center Full time

    Position Overview:The Senior PeopleSoft Business Systems Analyst plays a crucial role in guiding and engaging in comprehensive business process and data analysis initiatives to enhance our Institutional PeopleSoft Financial Supply Chain Management (FSCM) and associated third-party systems. Key Responsibilities:This role involves leading and providing...

  • Business Analyst

    2 months ago

    Houston, Texas, United States Horizontal Talent Full time

    Hybrid in Houston, TX. Open to candidates willing to travel in. BA's are needed with Market Risk, Trading and Power/Gas experience.*Key Responsibilities** - Endur ETRM Implementation and Management: Lead the configuration, implementation, and enhancement of the Endur ETRM system for settlement and risk management processes. Ensure seamless integration of...

  • Business Intelligence Analyst

    2 days ago

    Houston, Texas, United States Siri InfoSolutions Inc Full time

    About the RoleJob Title: Business Intelligence AnalystLocation: About the Role:Collaborate with leadership and business teams to optimize business processes, data flows, and business systems to measure against aspirational goals, strategic objectives, and performance targets.Facilitate work execution sessions, gap-to-goal analysis, and collaborative planning...

  • Lead Business Analyst

    7 days ago

    Houston, Texas, United States American National Full time

    American National is looking for a Senior Business Analyst to enhance our P&C Underwriting Division. This role is ideal for individuals with substantial experience in business analysis who are prepared to engage in large-scale initiatives while guiding fellow analysts.Key Responsibilities:• Gather, identify, and document comprehensive business requirements...

  • Lead Business Analyst

    7 days ago

    Houston, Texas, United States American National Full time

    American National is in search of a Senior Business Analyst to enhance our P&C Underwriting Division. This role is ideal for individuals with substantial experience in business analysis who are prepared to engage in large-scale initiatives while guiding fellow analysts within the team.Key Responsibilities:• Gather, define, and document comprehensive...

  • Lead Business Analyst

    2 days ago

    Houston, Texas, United States American National Full time

    American National is in search of a Senior Business Analyst to enhance our P&C Underwriting Division. This role is ideal for individuals with substantial experience in business analysis who are eager to engage in large-scale initiatives while guiding fellow analysts.Key Responsibilities:• Gather, identify, and document comprehensive business requirements...

  • Lead Business Analyst

    7 days ago

    Houston, Texas, United States American National Full time

    Position OverviewAmerican National is in search of a Senior Business Analyst to enhance our P&C Underwriting Division. This role is ideal for individuals with substantial experience in business analysis who are eager to engage in significant projects while guiding fellow analysts.Key ResponsibilitiesGather, articulate, and document comprehensive business...

  • Lead Business Analyst

    7 days ago

    Houston, Texas, United States American National Full time

    American National is in search of a Senior Business Analyst to enhance our P&C Underwriting Division. This role is ideal for individuals with substantial experience in business analysis who are eager to engage in significant projects while guiding fellow analysts.Key Responsibilities:• Gather, define, and document comprehensive business requirements along...

  • Lead Business Analyst

    2 days ago

    Houston, Texas, United States American National Full time

    American National is in search of a Senior Business Analyst to enhance our P&C Underwriting Division. This role is ideal for individuals with substantial experience in business analysis who are eager to engage in significant projects while guiding fellow analysts.Key Responsibilities:• Gather, define, and document comprehensive business requirements along...

  • Supply Chain Business Analyst

    7 days ago

    Houston, Texas, United States Collabera Full time

    Home Search Jobs Job Description Position: Business Analyst / Supply Chain Contract Type: Temporary Location: Hybrid Compensation: $35-40 per hour Role Overview:The Business Analyst will collaborate with management across various departments to develop and uphold the Schedule of Value (SOV), Statement of Work (SOW), and Item Master records essential for...

  • Procurement Business Analyst

    7 days ago

    Houston, Texas, United States Phillips 66 Full time

    Phillips 66 & YOU - Together we can fuel the futureThe Procurement Business Analyst plays a vital role within the Digital IT Business Solutions Corporate organization, ensuring that the Procurement Organization and associated support teams derive maximum business value and performance from IT services. This position focuses on Procurement IT initiatives and...

  • Business Continuity Analyst

    1 week ago

    Houston, Texas, United States Harvest Technical Services, Inc. Full time

    Position OverviewRole Summary: The Business Impact Analyst will play a crucial role in ensuring the resilience of our organization through effective business continuity planning and risk assessment.Key Responsibilities:Utilize a Business Continuity Planning (BCP) tool for effective data collection and ongoing maintenance.Revise and update existing Business...

  • Senior IT Business Systems Analyst

    7 days ago

    Houston, Texas, United States Burnett Specialists Staffing | Recruiting Full time

    Position: Principal IT Business Systems AnalystTravel Requirement: 20% Bonus Structure: 15% Remote Work: Candidates must reside in specific states.States: Florida, Georgia, Kansas, Michigan, Missouri, North Carolina, Ohio, South Carolina, Texas, West VirginiaThe role of the IT Business Systems Analyst is pivotal in assessing both business and technical...

  • Strategic Business Analyst

    7 days ago

    Houston, Texas, United States Weatherford Full time

    Job DescriptionCompany OverviewWeatherford is a premier global energy services provider. Our expert team collaborates with clients to maximize their resources and unlock the full potential of their assets. With a presence in manufacturing, research and development, service, and training facilities, we are the partner of choice for strategic solutions that...