HEDIS Program ManagerSolis Health Plans • Miami, FL, US
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HEDIS Program Manager
Solis Health Plans • Miami, FL, US
[job_card.30_days_ago]
[job_preview.job_type]
- [job_card.full_time]
[job_card.job_description]Bilingual in English & Spanish and / or Creole is preferred 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 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 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 Proficient with technology and computers Self-starter and independent worker Managed care experience is preferred Year-round record review experience is preferred
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.
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 :
Minimum Job Requirements :
Skills and Abilities :
Preferred qualifications :
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.
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