Hedis Quality Manager

Quality Manager

The Quality Manager will be responsible for creation and facilitation of training strategies. Programs to support an operational team. Responsible for abstraction of NCQA HEDIS Measures, CAPHS and HOS surveys to ensure operational milestones, gap closures, and overall success quality standards are attained and maintained.

In this role, the Manager will be expected to perform audits on all medical records and review the data to ensure records are accurate and able to assess the quality of patient care. It is crucial for the Quality Manager to have knowledge of CMS stars rating process, including, NCQA Quality measures, CAHPS and HOS programs and clinical standards and outcomes.

Essential Job Functions

• Manages, coordinates, and facilitates HEDIS Abstraction process by developing training, tools, and workflows to ensure all measures meet or exceed payor targets.
• Coordinates training related to external client facing programs; develops program success measures and performs periodic assessments or program success
• Assures compliance with corporate QI work plans.
• Assures that all QI activities are relevant to the needs of targeted population.
• Work Collaboratively with internal / external vendors
• Maintains effective documentation of research programs to meet regulatory and Accreditation Standards
• Provides oversight to assure accurate and complete qualitative analysis of clinical data and presentation of data analysis results.
• Develops, implements and oversees CAHPS and STAR measures quality metrics.
• Documentation detailing quality measures.
• Responsible for keeping our EHR / EMR system up to date
• Identified and correct any patient's information error
• Quality Spreadsheet
• CDSS / Alerts
• Quality Global Alerts

Minimum Required Education, Experience & Skills

Preferred Education, Experience & Skills

Physical & Mental Requirements (check all that apply)