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HEDIS Business Information Consultant

• Job Family: RDA > Business/Health Info

• Type: Full time

• Date Posted:Mar 01, 2024

• Anticipated End Date:Apr 30, 2024

• Reference: JR106334

Location:

• IN, INDIANAPOLIS

• MO, ST LOUIS

• NC, CARY

• FL, MIAMI

• NJ, ISELIN

• DE, WILMINGTON

• OH, CINCINNATI

• RI, SMITHFIELD

• KY, LOUISVILLE

• TX, GRAND PRAIRIE

• IL, CHICAGO

• GA, ATLANTA

• VA, RICHMOND

• TN, NASHVILLE

• GA, COLUMBUS

• IA, W DES MOINES

• DC, WASHINGTON

• MA, WOBURN

• MN, MENDOTA HEIGHTS

Description

HEDIS Business Information Consultant

Location: This position will work in a hybrid model (remote and office). The Ideal candidate will live within 50 miles of one of our Elevance Health PulsePoint locations.

The HEDIS Business Information Consultant is responsible for serving as an expert in data analysis, reporting and formulating recommendations, and providing guidance to team members and customers. This position is part of the Enterprise HEDIS Implementation Team. It will be responsible for working with management and peers on data ingestion, mapping, transformation, and reporting to support NCQA/CMS and State Medicaid agencies. The position may support multiple contracts inclusive of new market implementations, audits, benchmarking, testing, validation, and process improvement activities with a focus on data quality, accuracy, and completeness.

How You Will Make an Impact :

• Analyzes data and identifies trends and patterns; creates reports that illustrate data findings.

• Develops data quality metrics and standards for different types of data to ensure that it is high quality and error-free; communicates insights and recommendations to stakeholders.

• Creates and publishes periodic reports, as well as any necessary ad hoc reports.

• May require taking business issues and devising the best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools.

• Source to target mapping in conformance with software vendor specifications.

• Participates in system integration testing and unit acceptance testing; ensures data loads are error-free and meet data quality standards and user acceptance testing.

• Provides analytic consultation to other business areas, leadership, or external customers.

• Data analysis and reporting encompasses a much higher level of complexity.

Minimum Requirements:

Requires a BS/BA degree in a related field and a minimum of 5 years experience; or any combination of education and experience which would provide an equivalent background.

Preferred Skills, Capabilities, & Experiences:

• Experience with relational databases and knowledge of query tools and statistical software is strongly preferred including SQL & TOAD for SQL Server & Excel.

• 3-5 years experience querying/analyzing data from multiple platforms and formats highly preferred.

• The ability to manipulate large sets of data is strongly preferred.

• Strong analytical, organizational, presentation, and problem-solving skills strongly preferred.

• Excellent training and communication skills.

• Experience in HEDIS data & analytics preferred.

• Knowledge of healthcare industry standards and experience working with health insurance data such as enrollment, claims, membership, and provider data preferred.

• Experience working with NCQA, CMS, and State regulatory agencies and auditing firms is strongly preferred.

Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.

EEO is the Law

Equal Opportunity Employer / Disability / Veteran

Please use the links below to review statements of protection from discrimination under Federal law for job applicants and employees.

• EEO Policy Statement

• Know Your Rights

• Pay Transparency

• Privacy Notice for California Residents

Elevance Health, Inc. is anE-verify Employer (https://www.e-verify.gov/sites/default/files/everify/posters/EVerifyParticipationPoster.pdf)

Need Assistance?

Email us (elevancehealthjobssupport@elevancehealth.com)