Advertisement

Senior Manager, HEDIS Reporting Job Details

back to search results

Vacancy has expired

Company:  WellCare Health Plans, Inc.
Job Code:  1102914
Categories:  For-Profit Senior Services
Job Role:  LPN / LVN / Nurse
Region/Province:  Florida (FL)
City:  FL-Tampa
Job Description:  !*!About WellCare: WellCare Health Plans, Inc. provides managed care services targeted to government-sponsored health care programs, focusing on Medicaid and Medicare. Headquartered in Tampa, Florida, WellCare offers a variety of health plans for families, children, and the aged, blind, and disabled, as well as prescription drug plans. For more information about WellCare, please visit the Company's website at www.wellcare.com.

Our History: Founded in 1985 with three associates, WellCare grew to more than 800 associates and 467,000 members in Florida, New York and Connecticut by 2002. In 2004, the company acquired Harmony to enter the Midwest and became publicly traded. By 2006, WellCare served 2.2 million members as it became a national prescription drug plan provider and the largest Medicaid plan in Georgia. WellCare expanded its services when it began offering Medicaid managed care plans in Ohio and Missouri in 2007, and Medicare managed care plans in Texas and New Jersey in 2008. Additional growth followed when the company was chosen to serve Hawaii's Medicaid program for the aged, blind or disabled in 2009, and in 2011 when it was selected to serve Kentucky's Medicaid program. Today, WellCare has more than 3,900 associates and approximately 2.4 million members nationwide.

EOE: All qualified applicants shall receive consideration for employment without regard to race, color, religion, sex, age forty (40) and over, disability, veteran status, or national origin.
With the direction from Sr. Director, the Senior Manager, HEDIS Reporting oversees, designs, and manages operation and coordination of all aspects of Medicare and Medicaid Quality Improvement Reporting and Analysis functions within Informatics departments. The incumbent reviews and establishes analytical methodology for QI-processes and performance-based projects initiatives, including validation processes and the delivery of healthcare informatics services to all WellCare internal and external entities and agencies.

 

Essential Functions:


  • Defines and develops analytical methodologies and procedures to provide quantitative solutions for all QI initiatives and their implementations and delivery of automated solutions, by querying, collecting, analyzing, summarizing information & trends, and by providing consultancy to healthcare associates and analysts and programmers.

  • Manages projects & people and customers' expectations by holding primary responsibilities of performing and developing Quality Improvement measures (HEDIS type measures), performing intervention analysis, preparatory documents required for auditors, oversight agencies, and by using WellCare's database and member/provider information.

  • Provides quantitative analysis on various quality measures and health education by planning, collecting and analyzing proper sources of data, and by writing SAS and SQL codes to extract and analyze appropriate data sets.    

  • Assists the Senior Informatics Leaders by performing data analysis, maintaining project schedule, monitoring program progress, managing staff, and by maintaining and complying with regulatory requirements in collaboration with the compliance department.

  • Effectively manages internal and external vendor communications by collaborating and disseminating reports and defining program descriptions, and by sharing analytical findings with designated internal and external parties, and government regulators

  • Maintains professional and technical knowledge by attending educational workshops; reviewing and contributing to QI initiatives; establishing personal networks; participating in professional societies.

  • Performs other duties as assigned.

Education:  A Master's Degree in Quantitative area such as statistics, health science, or public health. PhD in quantitative/health sciences area preferred

 

Experience:   5 years experience in health care industry with a focus on QI and/or HEDIS analytics reporting. Experience working with clinical setting is an advantage.  2 years management experience

 

Special Skills (e.g. 2nd language): 


  • Considerable analytic skills necessary to provide efficient and effective solutions to enhance performance and productivity

  • Displays considerable judgment in the analysis of problems and significantly affect the financial performance

  • Strong analytical and problem solving skills

  • Ability to communicate effectively with people with varying levels of education

  • Ability to multitask in a fast paced environment

  • Strong leadership, management and administrative skills

  • Strong interpersonal skills, including excellent written and communication skills

  • Knowledge of and experience with health services industry and managed care business

  • Experience managing multiple research/report projects

  • Strong team player and ability to mentor people 


 

Technical Skills/Requirements: Strong SAS and SQL skills and database knowledge.  Solid skills in applied research methodology and advanced analytics.  Advanced in Microsoft Office such as Excel, Word, Visio, PowerPoint, Access, and Outlook.  Knowledge of BI (Business Intelligence) tool is an advantage
Post Date:  02/28/2012

Featured Jobs