HEDIS (Healthcare Effectiveness Data and Information Set) Operations Manager / NCQA HEDIS Analyst
Posted 2 days ago by VDart, Inc.
Negotiable
Undetermined
Remote
Remote
Summary: The HEDIS Operations Manager / NCQA HEDIS Analyst is responsible for overseeing end-to-end HEDIS operations, including data collection, abstraction, reporting, and audit readiness. This role requires expertise in NCQA HEDIS technical specifications and data analytics, along with strong collaboration skills to ensure compliance and accurate performance measurement. The position is remote and focuses on managing data quality and operational workflows. The ideal candidate will have a background in healthcare and experience with HEDIS audits and reporting tools.
Key Responsibilities:
- Support accurate HEDIS data collection, chart abstraction, validation, and reporting.
- Interpret and apply NCQA HEDIS technical specifications and measurement requirements.
- Monitor, track, analyze, and report HEDIS performance metrics and quality outcomes.
- Develop, maintain, and enhance operational workflows and business processes.
- Manage data quality, validate measure logic, and prepare metrics for internal reporting and audits.
- Coordinate end-to-end HEDIS processes, including chart chase, abstraction, and vendor management.
- Partner with clinical, operational, and technical teams to ensure data integrity and completeness.
- Track performance trends and identify opportunities for quality and compliance improvement.
- Support HEDIS audit activities, ensuring proper documentation, evidence, and audit artifacts are prepared and maintained.
- Work with SQL-based reporting, Power BI, and SSRS (Paginated Reports) to deliver insights and dashboards.
- Handle and analyze standard and non-standard healthcare data formats, including EDI, HL7, and custom files.
Key Skills:
- Strong knowledge of NCQA HEDIS specifications and healthcare quality measures.
- Proven ability in data interpretation, analytics, and reporting.
- Hands-on experience with SQL, Power BI, and SSRS (Paginated Reports).
- Experience managing data quality, validation, and audit readiness.
- Strong cross-functional communication and stakeholder collaboration skills.
- Familiarity with healthcare data standards such as EDI and HL7.
- Experience supporting HEDIS audits, chart abstraction, and vendor coordination.
- Background working in healthcare, managed care, or health plans preferred.
Salary (Rate): undetermined
City: undetermined
Country: USA
Working Arrangements: remote
IR35 Status: undetermined
Seniority Level: undetermined
Industry: Other
Job Title: HEDIS (Healthcare Effectiveness Data and Information Set) Operations Manager / NCQA HEDIS Analyst
Location: Remote, USA
Duration/Term: Long Term Contract
Job Description:
We are seeking an experienced HEDIS Operations Manager / Analyst to support end-to-end HEDIS operations, including data collection, abstraction, reporting, and audit readiness. This role requires strong expertise in NCQA HEDIS technical specifications, data analytics, and cross-functional collaboration to ensure accurate performance measurement and compliance.
Key Responsibilities:
- Support accurate HEDIS data collection, chart abstraction, validation, and reporting.
- Interpret and apply NCQA HEDIS technical specifications and measurement requirements.
- Monitor, track, analyze, and report HEDIS performance metrics and quality outcomes.
- Develop, maintain, and enhance operational workflows and business processes.
- Manage data quality, validate measure logic, and prepare metrics for internal reporting and audits.
- Coordinate end-to-end HEDIS processes, including chart chase, abstraction, and vendor management.
- Partner with clinical, operational, and technical teams to ensure data integrity and completeness.
- Track performance trends and identify opportunities for quality and compliance improvement.
- Support HEDIS audit activities, ensuring proper documentation, evidence, and audit artifacts are prepared and maintained.
- Work with SQL-based reporting, Power BI, and SSRS (Paginated Reports) to deliver insights and dashboards.
- Handle and analyze standard and non-standard healthcare data formats, including EDI, HL7, and custom files.
Qualifications
- Strong knowledge of NCQA HEDIS specifications and healthcare quality measures.
- Proven ability in data interpretation, analytics, and reporting.
- Hands-on experience with SQL, Power BI, and SSRS (Paginated Reports).
- Experience managing data quality, validation, and audit readiness.
- Strong cross-functional communication and stakeholder collaboration skills.
- Familiarity with healthcare data standards such as EDI and HL7.
- Experience supporting HEDIS audits, chart abstraction, and vendor coordination.
- Background working in healthcare, managed care, or health plans preferred.
Key Skills
HEDIS, NCQA HEDIS Specifications, SQL, Power BI, SSRS, Data Analytics, Data Quality, Workflow Management, Chart Abstraction, Vendor Management, EDI, HL7, Healthcare Reporting
VDart Group is a global leader in technology, product, and talent solutions, serving clients including Fortune 500 companies across 13 countries. With over 4,000 professionals, we deliver innovation and results across industries. Committed to People, Purpose, and Planet, we are recognized for our sustainable practices through our EcoVadis Bronze Medal and UN Global Compact membership.