Remote HEDIS Clinical Quality Analyst - RN/CPHQ Preferred
Alliance
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Descripción de la vacante
Alliance is seeking a qualified HEDIS Clinical Quality Analyst to provide clinical direction, oversight, and training related to HEDIS for NCQA and CMS compliance. This remote role supports NC-based policies with occasional in-office meetings.
Ideal candidate has RN or LPN licensure and 5+ years of healthcare HEDIS quality experience, plus familiarity with NCQA Tech Specs and QA processes. Strong Excel and analytical skills are essential.
Formación
- RN license or LPN with nursing degree.
- Minimum five years healthcare experience in HEDIS quality and process improvement.
- Familiarity with NCQA Technical Specifications and Value Set Directory.
- Experience with Medical Record Abstraction/Quality Analysis for HEDIS.
- Knowledge of NCQA HEDIS data collection and reporting requirements.
Responsabilidades
- Oversee HEDIS projects and act as SME for NCQA HEDIS measures.
- Review internal HEDIS processes for alignment with procedures and best practices.
- Coordinate Primary Source Verification and MRV Audits.
- Manage data analysis, quality reports, and improvement activities.
- Provide training and consultation to project teams.
Conocimientos
Educación
Descripción del empleo
Alliance is seeking a qualified HEDIS Clinical Quality Analyst to provide clinical direction, oversight, and training related to HEDIS for NCQA and CMS compliance. This remote role supports NC-based policies with occasional in-office meetings.
Ideal candidate has RN or LPN licensure and 5+ years of healthcare HEDIS quality experience, plus familiarity with NCQA Tech Specs and QA processes. Strong Excel and analytical skills are essential.
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