HEDIS Data Quality Program Lead

Blue Cross Blue Shield Association; Chicago (IL); On-site; USD 113,000 - 153,000; Full time

Benefits offered by this job

Paid time off

11 holidays

Medical/dental/vision insurance

401(k) matching

Job summary

Blue Cross Blue Shield Association is seeking a specialist to lead HEDIS data quality and submission efforts for NCQA. You will oversee the HEDIS portal, profile QCR data, and drive cross-functional quality improvements across plans and vendors.

You will apply extensive HEDIS technical knowledge to optimize data improvement strategies, perform data mining, and deliver actionable analyses to enhance overall HEDIS performance.

Qualifications

• Bachelor's Degree or equivalent experience.
• 7+ years in a business/healthcare environment with operations, claims processing and informatics.
• Strong written and verbal communication with audiences of varied sizes.
• Advanced analytic skills and data interpretation ability.
• Knowledge of SAS, SQL, Cognos, or MCSource.

Responsibilities

• Develop, communicate, and monitor quality standards for HEDIS with a focus on data strategy and reporting.
• Support end-to-end testing, optimize data, address defects, and implement resolutions.
• Create presentations and content for partners and conferences to ensure proper execution.
• Maintain relationships with Quality departments to support HEDIS reporting and ensure data integrity.

Skills

SAS

SQL

Cognos

MCSource

Analytic skills

Communication

Education

Bachelor's Degree

Tools

SAS

SQL

Cognos

MCSource

Job description

Blue Cross Blue Shield Association is seeking a specialist to lead HEDIS data quality and submission efforts for NCQA. You will oversee the HEDIS portal, profile QCR data, and drive cross-functional quality improvements across plans and vendors.

You will apply extensive HEDIS technical knowledge to optimize data improvement strategies, perform data mining, and deliver actionable analyses to enhance overall HEDIS performance.