HEDIS Operations Specialist

4 weeks ago


Grand Rapids, Michigan, United States Corewell Health Full time
Job Summary

Corewell Health is seeking a highly skilled HEDIS Operations Specialist to play a pivotal role in elevating our health plan ratings and making a meaningful impact on the lives of our patients and members. As a key member of our team, you will be responsible for coordinating and delivering critical milestones to ensure we meet NCQA HEDIS standards.

Key Responsibilities
  • Provide operational support for new and existing programs and projects, ensuring required documentation, reporting, data collection, and database utilization are performed in an accurate and timely manner.
  • Collect and analyze process, productivity, value, and quality-related data to initiate, develop, and recommend operational practices and procedures that focus on operational efficiency, enhanced safety, increased productivity, and reduced cost.
  • Engage in process and quality improvement initiatives, responsible for implementing recommendations to improve operational efficiency, new services for the area of responsibility, and creating documentation of new established workflows.
  • Serve as the operational lead to provide structure, project management, and direction for new and existing workflow transformation and other operational initiatives, collaborating with leadership to develop action and project plans focused on operations and running the business.
  • Assist with the coordination of compliance activities to ensure services are provided in accordance with State and Federal regulations, organizational policies and procedures, medical staff bylaws, and accreditation/compliance requirements.
About Corewell Health

As a team member at Corewell Health, you will play an essential role in delivering personalized healthcare to our patients, members, and communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders, and innovators that continue to build on one shared mission statement - to improve health, instill humanity, and inspire hope.

Qualifications
  • Bachelor's Degree or equivalent in business, healthcare administration, or a related field.
  • 3 years of relevant experience related to leadership.
  • Experience in healthcare and working within an organization of size and complexity comparable to Corewell Health is preferred.


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