Talent.com
HEDIS Program Manager
HEDIS Program ManagerSolis Health Plans • Miami, FL, US
[error_messages.no_longer_accepting]
HEDIS Program Manager

HEDIS Program Manager

Solis Health Plans • Miami, FL, US
[job_card.variable_days_ago]
[job_preview.job_type]
  • [job_card.full_time]
[job_card.job_description]

Job Description

Job Description

HEDIS Program Manager

About us :

Solis Health Plans is a new kind of Medicare Advantage company. We provide solutions that are transparent, connected, and effective for both our members and providers. Solis was created with a desire to offer a more personalized experience throughout every stage of the healthcare journey. Our team consists of experts who take pride in delivering quality service. We foster a culture of collaboration and support, where success is shared, and every employee is valued.

To learn more about us, please visit our website at www.solishealthplans.com!

  • Position is fully onsite Monday-Friday

Location : 9250 NW 36th St, Miami, FL 33178.

  • Bilingual in English & Spanish and / or Creole is preferred

    • Full benefits package offered on the first day of the month following the date of hire including : Medical, Dental, Vision, 401K plan with a 100% company match!

    Our health plan membership has grown exponentially from 2,000 to almost 15,000 members in the last year!

    Join our winning Solis Team!

    Position Summary :

    This position is responsible for overseeing HEDIS and quality measure projects, managing project plans, vendors, and timelines, and collaborating with various internal and external teams to improve HEDIS compliance and audit readiness. Key duties involve leading outreach efforts for members and providers, performing medical record reviews, and analyzing data to identify gaps and drive performance improvement initiatives.

    Essential Functions and Duties :

  • Project and program management : Develop and manage project plans, timelines, and deliverables for HEDIS initiatives. This includes ensuring projects adhere to quality standards and managing project budgets.
  • HEDIS operations and audits : Oversee HEDIS data submission, auditing, and hybrid chart abstraction processes. Act as a subject matter expert during the annual HEDIS audit.
  • Stakeholder collaboration : Collaborate with internal and external stakeholders, including clinical, operations, and compliance teams, as well as providers and vendors.
  • Performance improvement : Drive performance improvement by analyzing data, identifying gaps in care, and developing and implementing action plans. This includes developing strategies for member and provider outreach.
  • Data analysis and reporting : Oversee HEDIS performance data, create and summarize reports for management, and validate dashboards for executive stakeholders.
  • Communication : Communicate project status, risks, and issues effectively to all stakeholders.
  • Training and education : Facilitate HEDIS-related training and educational materials for internal staff, providers, and members.
  • Additional duties as assigned

    • Minimum Job Requirements :

  • Bachelor’s degree in science or healthcare and / or equivalent relevant experience in the HEDIS project under a managed care organization
  • 3+ year of quality management or project management experience is required
  • Willing to travel locally to provider offices

    • Skills and Abilities :

  • Experience with HEDIS, NCQA (National Committee for Quality Assurance), and CMS Star ratings programs.
  • Strong project management, organizational, and communication skills.
  • Excellent analytical and problem-solving skills.
  • Experience with data analysis and reporting.
  • Ability to manage multiple complex projects simultaneously.
  • Familiarity with health plan operations, medical records, and quality metrics.
  • Strong attention to detail and documentation skills.
  • Proficiency with Microsoft Office applications.
  • Excellent communication skills, including strong writing and presentation delivery

    • Preferred qualifications :

  • Proficient with technology and computers
  • Self-starter and independent worker
  • Managed care experience is preferred
  • Year-round record review experience is preferred

    • Required Languages : What sets us apart :

    Join Solis Health Plans as a HEDIS Program Manager and become a catalyst for positive change in the lives of our members. At Solis, you will be part of a locally rooted organization deeply committed to understanding and serving our communities. If you are eager to embark on a purpose-driven career that promises growth and the chance to make a significant impact, we encourage you to explore the opportunities available at Solis Health Plans. Join us and be the difference.

    [job_alerts.create_a_job]

    Program Manager • Miami, FL, US

    [internal_linking.similar_jobs]
    Program Manager Non Tech

    Program Manager Non Tech

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Program Manager Non Tech 3.Key Responsibilities Coordinate projects by developing detailed plans and overseeing integration of activities Present and explain proposals...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    GTM Program Manager

    GTM Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a GTM Program Manager to drive go-to-market excellence across the organization.Key Responsibilities Lead and execute operational and transformational workstreams to enhan...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Medicare Duals Program Director

    Medicare Duals Program Director

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Program Director - Medicare Duals (REMOTE).Key Responsibilities Manage internal business projects and programs, overseeing cross-functional teams and external vendors ...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Senior Technical Program Manager

    Senior Technical Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Senior Technical Program Manager to lead complex, cross-functional projects from inception to launch. Key Responsibilities Manage complex, cross-functional programs invo...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Senior Enablement Program Manager

    Senior Enablement Program Manager

    VirtualVocations • Coral Gables, Florida, United States
    [job_card.full_time]
    A company is looking for a Senior Enablement Program Manager.Key Responsibilities : Execute, operationalize, and refine enablement systems and tools to support central programs and market strategi...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Health System Implementation Manager

    Health System Implementation Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Health System Implementation Program Manager.Key Responsibilities Manage and oversee implementation initiatives, ensuring projects meet scope, budget, and timeline Dev...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Sales Enablement Program Manager

    Sales Enablement Program Manager

    VirtualVocations • Coral Gables, Florida, United States
    [job_card.full_time]
    A company is looking for a Sales Enablement Program Manager to support the design, delivery, and sustainment of enablement experiences across sales technology systems. Key Responsibilities Support...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Program Manager

    Program Manager

    Syntricate Technologies • Miami, FL, US
    [job_card.full_time]
    Location : Remote Duration : Contract.Strategize, implement, and maintain program initiatives that adhere to organizational objectives. Develop program assessment protocols for evaluation and improvem...[show_more]
    [last_updated.last_updated_30] • [promoted]
    PROGRAM MANAGER, CPMO (INTEGRATION AND IMAGING)

    PROGRAM MANAGER, CPMO (INTEGRATION AND IMAGING)

    Healthcare Systems of America • Coral Gables, FL, USA
    [job_card.full_time]
    [filters_job_card.quick_apply]
    WE ARE HEALTHCARE SYSTEMS OF AMERICA.Our mission is to elevate healthcare standards, improve patient outcomes, and create value for communities across the United States. Healthcare Systems of Americ...[show_more]
    [last_updated.last_updated_30]
    Technical Program Manager

    Technical Program Manager

    VirtualVocations • Coral Gables, Florida, United States
    [job_card.full_time]
    A company is looking for a Technical Program Manager to lead and optimize core system integration projects.Key Responsibilities : Oversee new and existing core system integration projects, ensurin...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Program Manager

    Program Manager

    VirtualVocations • Coral Gables, Florida, United States
    [job_card.full_time]
    A company is looking for a Program Manager, One-Stop Shop.Key Responsibilities Shape and operationalize programs that connect agents with loan officers to drive client success Develop metrics an...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Healthcare EDI Program Manager

    Healthcare EDI Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Healthcare Electronic Data Interchange Program Manager.Key Responsibilities Manage assigned program(s) to meet business objectives and oversee installations, conversion...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Program Manager IV - Healthcare

    Program Manager IV - Healthcare

    VirtualVocations • Coral Gables, Florida, United States
    [job_card.full_time]
    A company is looking for a Program Manager IV - Product Development.Key Responsibilities Develop, implement, manage, and maintain operational systems and activities Serve as a liaison with all l...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    In-Market Technical Program Manager

    In-Market Technical Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for an In Market Technical Program Manager.Key Responsibilities Own the end-to-end software release process for in-market wearable products, including planning, execution, an...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]
    Product Operations Program Manager

    Product Operations Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Product Operations Program Manager.Key Responsibilities Manage day-to-day squad operations and facilitate regular stand-up meetings Support agile delivery cycles and m...[show_more]
    [last_updated.last_updated_1_day] • [promoted]
    Principal Program Manager

    Principal Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Principal Program Manager to lead large multi-year strategic programs focused on evolving and scaling Athlete Experience. Key Responsibilities Oversee all aspects of pro...[show_more]
    [last_updated.last_updated_30] • [promoted]
    Public Trust Technical Program Manager

    Public Trust Technical Program Manager

    VirtualVocations • Miami, Florida, United States
    [job_card.full_time]
    A company is looking for a Technical Project Manager (Infrastructure / Enterprise Support).Key Responsibilities Lead and manage the full lifecycle of engineering projects, ensuring adherence to sco...[show_more]
    [last_updated.last_updated_variable_days] • [promoted]
    Training & QA Program Manager

    Training & QA Program Manager

    VirtualVocations • Coral Gables, Florida, United States
    [job_card.full_time]
    A company is looking for a Training & Quality Assurance Program Manager for the Customer Experience team.Key Responsibilities Manage training and quality assurance programs, including audits and ...[show_more]
    [last_updated.last_updated_variable_hours] • [promoted] • [new]