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The Associate Director, HEDIS Operations of Non-Standard Supplemental for business operations supports all aspects of configuration control, data management, and deficiency reporting. The Associate Director, Data Management requires a solid understanding of how organization capabilities interrelate across department(s).

The Associate Director of HEDIS Non-Standard Supplemental Operations supports all aspects of the non-standard supplemental (NSS) program; including: systems readiness, process improvements, resource deployment, technology implementation, and data management/reporting.  The Associate Director of HEDIS Non-Standard Supplemental Operations requires a solid understanding of how organization capabilities interrelate across department(s) throughout the enterprise.  This role creates a collaborative environment for their team and partners to determine, and oversee execution of, numerous strategies required to ensure success for our Medicare Stars and Medicaid LOBs. The ideal candidate for this role will thrive in a fast-paced and complex working environment, demonstrates a high level of business and operational acumen, have experience in executing high-priority projects with full accountability, monitor and respond to performance, and cultivate and mature partnerships within the enterprise.

• Become an expert in HEDIS & Stars specifications, processes, and schedules

• Interpretation of the NCQA technical specifications and regulatory audit requirements to partner on data/process updates; and to provide insights, impacts and guidance to the enterprise

• Execution and oversight of seasonal program deliverables; including monitoring both current and upcoming weekly deliverables, ensuring satisfaction of program milestones, and providing transparency into potential risks

• Governance of stakeholder deliverables, standards, timelines, milestones, escalations, and issue resolution

• Provide leadership and management for the NSS season to ensure optimal outcomes from clinical reviews

• Development and maintenance of operational workflows, processes, use of technology and systems

• Drive development of new and upcoming systems to complement the operational process and increase productivity

• Support clinical quality improvement by championing continuous improvements to operational processes and systems/tools development

• Partner to drive and oversee comprehensive program to support quality improvements and holistic data capture

• Manage multiple data sets from varying systems to inform resource needs, data value, and report metrics

• Interpretation and presentation of data to identify trends and opportunities for improved member health and measure compliance

• Internal and external partnerships to coordinate, guide, direct and oversee day-to-day HEDIS activities, including: contingency planning and mitigation, communications, metrics, reporting and prioritization

• Identify opportunities across HEDIS processes to ensure compliance and audit requirements are satisfied, while also simultaneously maximizing gap closure

• Assist with vendor staffing, strategy, and feedback assessment

Use your skills to make an impact
 

Role Essentials

• Bachelor's Degree or equivalent work experience

• 6+ years of relevant experience in operations and/or project management

• 2 or more years of management/people leader experience

• Demonstrated ability to articulate ideas effectively in both written and oral forms

• Be agile and adaptable to shifting priorities

• Proficient in balancing numerous projects and resource pools simultaneously

• Able to learn and leverage multiple systems and data sets

• Self-starter who assumes accountability for their team’s success and strives to maximize results for the enterprise

Role Desirables

• Master's Degree in Business Administration or a related field

Additional Information

To ensure Home or Hybrid Home/Office employees’ ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wire