Manager, HEDIS Operations

🔥 14 hours ago

🇺🇸 United States – Remote

💵 $126.4k - $189.6k / year

⏰ Full Time

🟡 Mid-level

🟠 Senior

⚙️ Operations

👻 Ghost score 0%

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Alignment Health

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 2013

⚕️ Healthcare Insurance

🛡️ Insurance

🏥 Healthcare

💰 $135M Series C on 2020-03

Healthcare Insurance • Insurance • Healthcare

Alignment Health is dedicated to providing comprehensive care for Medicare members, emphasizing the needs of seniors, the chronically ill, and those who are frail. With a mission to transform senior healthcare, Alignment Health leverages a tailored care model and advanced technology to deliver high-quality, low-cost healthcare services. Their 24/7 concierge care team collaborates with trusted local providers to ensure that every member receives personalized care, reflecting the company's commitment to treating all members as valued family members.

📋 Description

• Translate business requirements into specifications for reports and dashboards • Design and publish custom dashboards for business functions, stakeholders, and corporate users • Design, model, develop, and optimize stored procedures for data management and reporting • Support HEDIS data collection, data abstraction, and reporting • Interpret and apply NCQA HEDIS technical specifications and measurement requirements • Monitor, track, analyze, and report HEDIS performance metrics • Develop, maintain, and improve HEDIS/STAR workflows and processes • Manage data quality, validate measure logic, and prepare metrics for reporting and audits • Coordinate end-to-end HEDIS processes, including chart chase, abstraction, and vendor management • Partner with clinical and operational teams, vendors, and systems to ensure data integrity and completeness • Track performance trends and identify compliance improvement opportunities • Support end-to-end HEDIS audit activities, including documentation and artifacts • Create functional and technical design documents and maintain report and dashboard documentation • Improve team workflows, establish development practices, and monitor project progress through agile stand-ups and planning sessions • Maintain documentation and team standards for tools and processes

🎯 Requirements

• 6+ years of business intelligence and reporting experience • 6+ years of experience with BI/reporting software products (MSBI) and healthcare industry standards and requirements • 6+ years of strong data interpretation and analytic skills • 3+ years of HEDIS/STAR workflow and process development • Strong SQL skills • Power BI and SSRS (Paginated Report) experience • Knowledge of EDI, HL7, and custom file formats • Extensive hands-on experience with Power BI, SSRS, SSAS, Azure Data Factory, and cloud-based BI/reporting services • Experience with Big Data/Azure Data Platform is a plus • Experience with Azure, AWS, or GCP is a plus • BS in Computer Science, IT, or equivalent and/or equivalent experience • Microsoft Azure Certification is a plus • Strategic and analytical thinking to translate data into insights • Strong organizational and project management skills • Knowledge of data governance and quality best practices

🏖️ Benefits

• Ample room for growth and innovation • Reasonable accommodation for individuals with disabilities • Equal Employment Opportunity and Affirmative Action