Clinical Quality Reporting Manager

2 weeks ago


Topeka, Kansas, United States Blue Cross and Blue Shield of Kansas Full time

Position Overview: The Clinical Quality Reporting Manager is responsible for overseeing the corporate operations related to HEDIS and supplemental data management. This role ensures adherence to regulatory standards while supporting quality initiatives aimed at enhancing member health outcomes across various business lines.

Key Responsibilities:

  • Lead a dedicated team in managing clinical quality data processes, ensuring efficient data ingestion, storage, and reporting.
  • Act as a subject matter expert to uphold the quality and integrity of health information technology systems.
  • Establish and maintain a comprehensive directory of clinical quality data resources, reports, and analyses.
  • Collaborate with internal and external stakeholders to ensure compliance with CMS and NCQA standards.
  • Build and nurture relationships with providers and health information networks to guarantee the accuracy of health data.
  • Conduct thorough analyses to identify care gaps and support quality improvement initiatives.
  • Coordinate with auditors and relevant stakeholders to ensure timely access to necessary data for audits and reports.
  • Oversee training and processes related to patient records and quality measures.
  • Monitor clinical quality metrics and assist in population health initiatives.
  • Engage in regular meetings with leadership to assess quality metrics and address barriers to improvement.

Qualifications:

  • A bachelor's degree in health informatics, health administration, public health, business administration, or a related field.
  • A minimum of 5 years of relevant experience, or 10 years of applicable work experience in lieu of a degree.
  • Demonstrated leadership capabilities and experience.

Preferred Qualifications:

  • Post-graduate degree in a relevant field.
  • Completion of leadership programs.
  • Familiarity with HEDIS, EHR, and healthcare industry standards.
  • Previous experience in project management.

Benefits:

  • Competitive compensation package with performance incentives.
  • Comprehensive health, vision, and dental insurance.
  • Generous parental leave and caregiver leave policies.
  • 401(k) plan with matching contributions.
  • Tuition reimbursement and health & fitness benefits.


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