Health Services for Children with Special Needs, Inc. (HSCSN) in Washington, DC is seeking a experienced healthcare analyst to develop and lead our HEDIS program. In this position you will be responsible for managing Healthcare Effectiveness Data and Information Set (HEDIS) and CAHPS Child, Child Chronic Condition and Adult Member satisfaction surveys projects for HSCSN. This role works with the HSCSN management team, IT department, and external vendors to produce the required performance measures for annual HEDIS reporting including, but not limited to, completion of HEDIS road map, HEDIS audit, IDSS submission to NCQA, and participates in state reporting required QI collaborative measures, performance measures, performance measure validation audit, PIP reporting, and non-HEDIS quality management metric reporting as per our Child and Adolescent Supplemental Security Income Program (CASSIP) contract with the DC Department of Health Care Finance. This position will monitor HEDIS data collection, conduct data analysis, coordinate medical record review, and outreach activities including identifying gaps in care and recommending ongoing improvement and maintenance.
Minimum Experience Requirement: Five (5) or more years in Medicaid and/or Medicare health care and insurance industry, including federal regulatory and compliance requirements and health care quality and performance improvement. Three (3) or more years of experience in the management of all HEDIS performance measurement and reporting; development of provider/member initiatives with proven success. Previous supervisory experience required; three (3) years or more clinical background experience preferred. Prior HEDIS project management experience is required. Proficiency in software applications that include but not limited to Microsoft Word, Excel, Power point, and Access; prior use of Verisk certified software preferred. Excellent verbal and written communication skills, ability to speak clearly and concisely, conveying complex or technical information in a manner that others can understand, as well as ability to understand and interpret complex information from others.
Minimum Education Requirement: Bachelor’s Degree in health care field required and MSN, MPH, MPA or MBA preferred.
Minimum Licensure Requirement: Registered Nurse (RN) preferred, RN must be licensed in the District of Columbia, if applicable. CPHQ preferred (must obtain with 18 months of employment).
Washington, DC residents are strongly encouraged to apply.
About Health Services for Children with Special Needs, Inc.
Health Services for Children with Special Needs, Inc. (HSCSN) is a dedicated District of Columbia Medicaid health plan that coordinates health, social, and education services for the pediatric Supplemental Security Income (SSI) and SSI-eligible populations of Washington, DC.
Exclusively focused on children and young adults with special health care needs up to age 26, our plan is impressively c...omprehensive. Our dedicated, caring staff of health care professionals is genuinely committed to helping our members and their families reach their full potential.