Amerigroup, a proud member of the Anthem, Inc. family of companies, is focused on serving Medicaid, Medicare and uninsured individuals and families. We improve access to quality health care for the financially vulnerable, seniors and people with disabilities.
Here, you can do work that matters and offers opportunities for personal and professional growth. Together, our associates are transforming health care with trusted and caring solutions.
HEDIS Manager (RN Preferred) Iselin, NJ 120880
This is an office based position in the NJ Health Plan of Amerigroup, located in Iselin, NJ.
The HEDIS Mgr. is responsible for coordinating, implementing, and executing HEDIS Quality Department specific projects, ensuring consistency with company strategy, commitments, and goals.
Primary duties may include, but are not limited to:
• Leads and manages annual HEDIS process within plan or region; serves as subject matter expert to enterprise team.
• Identifies, develops, and improves processes, procedures, and operations, conducts analysis, leads cross functional teams, and schedules, develops, and implements initiatives to strategically improve project processes.
• Secures and coordinates resources, temporary staff, space and equipment, and system requirements.
• Evaluates and monitors performance and efficiency of programs to ensure that implementation meets targeted timelines.
• Develops strategy with multiple enterprise departments and external vendor to annually field a new HEDIS pursuit application.
• Synthesizes performance data, prepares presentation materials, and presents comparative complex reports to local and enterprise quality committees.
• Builds relationships with internal and external customers.
Requires a BA/BS in public health, nursing or related field; 5 years of experience involving direct health care background and analyses of health care data, including 1 years of experience with HEDIS activity coordination and experience working with Managed/Acute/ Provider Care environment; or any combination of education and experience, which would provide an equivalent background.
• Masters in Public Health, Health Services Administration, Nursing, or Business Administration preferred.
• Leadership experience preferred.
• RN, RHIA or RHIT and CPHQ license preferred.
• NCQA and HEDIS experience
• Current active, unrestricted clinical license (RN or higher level) in the state of New Jersey strongly preferred.
• Experience working with HEDIS, EPSDT, medical record audit or review.
• Experience managing HEDIS projects.
• Experience with Quality Improvement and Corrective Action plans.
• Experience working in a health insurance company or Medicaid, managed care setting.
• Must have excellent communication skills (written and verbal), interpersonal skills, project management and organizational skills.
• Must have excellent PC skills (Word, Excel, Outlook)
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine, and is a 2014 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company please visit us atantheminc.com/careers. EOE. M/F/Disability/Veteran.__
Job Business Support
Title: HEDIS Manager (RN Preferred) Iselin, NJ - 120880
Other Locations: New Jersey
Requisition ID: 120880
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