Nurse Manager of Quality Initiatives & HEDIS
Job Description & Responsibilities:
- Responsible for the development, coordination and implementation of all HEDIS, CAHPS and HCC-related improvement projects.
- Responsible for coordinating, implementing, monitoring and measuring the progress of all selected improvement plans and for measuring the performance/outcomes of such efforts on a continual basis.
- Responsible for bringing together multiple departments to engage and enlist their input, recommendations and actions on actionable interventions geared toward HEDIS, CAHPS and HCC performance improvement.
- Oversight of the Encounter Data process, ensuring timely, valid, reliable reporting to State, Federal and NCQA regulators.
- Required to coordinate, implement, monitor, measure and perform analyze to the progress of all selected improvement plans and for measuring the performance/outcomes of such efforts on a continual basis.
- Test reports for accuracy and correctness of data
- Ensure data integrity by identifying, researching and working with other team members to resolve discrepancies when integrity issues arise
- Help validate reporting results from other departments
- Create documentation detailing process/procedure/logic of how reporting was developed
- Analyze both ad-hoc and ongoing reports for trends in data and/or answer specific business questions that need to be addressed within the organization as required.
- Maintain and distribute regular reports on an ongoing (daily/monthly/quarterly/annual) basis
- Participate in special projects and lead ad-hoc reporting requests
- Manage day-to-day operational aspects of multiple projects simultaneously
- Effectively communicate project expectations to team members and stakeholders in a timely and clear fashion.
- Set and continually manage project expectations with team members and other stakeholders.
- Delegate tasks and responsibilities to appropriate personnel.
- Leading and supports PDCA initiatives.
- Supports performance metrics.
- Supports the overall quality improvement initiatives.
- BSN required; Master’s Degree preferred
- Current RN license
- Minimum of five (5) years’ in statistical and research methods or HEDIS reporting and improvement
- Minimum of five (5) years’ experience in research and data analysis
- Managerial experience required