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HEDIS Business Analyst

2 months ago


Long Beach, California, United States Blue Shield of California Full time
About the Role

This dynamic role supports the collection and validation of HEDIS supplemental data sources for Clinical Quality Analytics. The Business Analyst will be responsible for providing operational support to the Supplemental Data Team and maintaining communications and documentation amongst various stakeholders. This role will also facilitate meetings with internal and external stakeholders and support various HEDIS and quality improvement efforts.

Your Responsibilities
  • Provide ongoing support for HEDIS supplemental data collection and validation, including assistance with internal and external audits on supplemental data and NCQA HEDIS roadmaps.
  • Manage and triage supplemental data questions and requests in the HEDIS Supplemental Data mailbox, including documenting incoming file transfers and moving files to the appropriate file processing locations.
  • Review and understand annual HEDIS specifications as it relates to supplemental data to update and maintain tool kits and communicate requirements to internal and external stakeholders.
  • Ability to translate technical findings into actionable steps for internal and external stakeholders.
  • Facilitate virtual clinical meetings / training with internal and external stakeholders.
  • Communicate adherence to established supplemental data guidelines and deadlines to internal and external stakeholders.
  • Review and manage incoming projects requests.
  • Support ad hoc Quality Improvement projects across the enterprise.
Requirements
  • Typically, requires a college degree or equivalent experience and 3+ years of healthcare or HEDIS / clinical quality experience with an emphasis on understanding how data quality impacts care gaps.
  • Working knowledge of NCQA and HEDIS programs.
  • Provider and/or vendor engagement/education experience.
  • Comprehensive knowledge of Microsoft Office applications, including Word, Excel and PowerPoint.
  • Strong attention to detail and knowledge of project management concepts.
  • Strong verbal and written communication and presentation skills.
  • Ability to multitask and use agile thinking in a fast-paced environment with frequent interruptions and changing priorities.