HEDIS Audit Quality Manager (State and NCQA)
Core
Managing HEDIS audit activities and ensuring compliance for submissions to NCQA, CMS, and State Regulatory Agencies.
Role type
Senior HEDIS Audit Quality Manager
Builds
Audited HEDIS and CAHPS results for regulatory agencies
Domain
Healthcare / Health Insurance / Quality Measurement
Deliverable
client delivery
Required skills
HEDIS audit guidelines interpretation, project management, quantitative and qualitative data analysis, resource identification, stakeholder interface, compliance reporting
Preferred skills
Medicaid state audit experience, NCQA HEDIS process expertise, large project plan creation, mock interview leadership
Technologies
None explicitly stated
Responsibilities
Manage overall HEDIS audit processes and resources, evaluate and interpret HEDIS guidelines, lead quality studies and projects, coordinate state-specific audits, perform data analysis for quality committees, facilitate work plans and timelines
Seniority
Senior, hands-on IC
