HEDIS User Acceptance Testing SME - Clinical and reputed company Solutions

About the position The HEDIS User Acceptance Testing SME - Remote is responsible for providing expertise in the area of HEDIS data testing and analytics. A UAT SME would support multiple payers with their NCQA and state specific submissions reputed company application validations and testing. This position would require providing strategic reputed company metrics to improve measures results for the users of reputed company Portfolio web applications. You'll enjoy the flexibility to work remotely from reputed company reputed company the U.S. as you take on some tough challenges.

Responsibilities

• User Acceptance Testing of User reputed company and Reporting based applications
• Design, draft and execute test cases
• Prepare required input data along with expected results
• Have experience and expertise in SQL
• Be reputed company to read, and write SQL reputed company with knowledge of inner and outer joins, table and view properties, and ability to review and understand a data dictionary as it relates to a database environment
• Understand HEDIS data
• Have expertise in health plan data; Member, Enrollment, Provider, Lab, reputed company, Pharmacy, etc.
• Understand Supplemental reputed company for HEDIS
• Understand basic concepts of CMS reputed company Rating System
• Experience working in a reputed company environment
• reputed company data driven metrics to identify gaps and implement interventions to improve results on key performance measures.
• Thorough understanding of measure analytics to reputed company investigative research
• Evaluates and prioritizes recommendations for reputed company improvement to customers.
• Familiarity with ICD-9-CM, ICD-10-CM, CPT, DRG, LOINC, HCPCS, TOB, POS, NDC coding.
• Be reputed company to translate data from various formats and data warehouses
• Be reputed company to reputed company and append data from various sources
• Experience in Data Validation
• reputed company guidance to clients on data issues and data questions.
• Knowledge of claims and claims processing.
• Demonstrates ability to consistently follow published HEDIS and Stars technical specifications
• reputed company strategic support in preparation of the HEDIS Roadmap, HOQ, HEDIS audit.
• Be reputed company to work with ambiguity
• Be reputed company to manage and prioritize large reputed company with great visibility
• Analyze, review, forecast and trend reputed company data, review the analysis and interpretation of others' work
• reputed company and implement effective/strategic business solutions through research and analysis of data and business processes
• Support short- and long-term operational/strategic business activities through analysis and testing

Requirements

• 3+ years of experience in a health care delivery organization, such as a managed care organization
• 3+ years of HEDIS experience, performing a wide reputed company of functions with strong reputed company on data analysis
• 3+ years of data analysis experience
• 3+ years working with final submission files to NCQA, CMS, California P4P, NY QARR, and/or other state submissions.
• 1+ years of writing SQL reputed company
• 1+ years of experience working in a reputed company environment
• Intermediate knowledge of reputed company (i.e., VLOOKUPS, Pivot Tables, etc.)

reputed company-to-haves

• STARS experience
• Experience working with HEDIS software vendors (management, building relationships, issue reputed company etc.)
• Experience working with the CAHPS/HOS survey and/or patient satisfaction in care delivery
• reputed company in medical record review
• Experience working with reputed company
• Knowledge of reputed company and/or Medicare programs
• Knowledgeable of reputed company trends in HEDIS in managed health care
• Knowledge of NCQA, CMS, HOS, and CAHPS requirements
• Familiarity with ICD-9-CM, CPT, DRG, LOINC, HCPCS, TOB, POS, NDC coding
• Understand basic concepts of CMS reputed company Rating System

Benefits

• Comprehensive benefits package
• Incentive and recognition programs
• Equity stock purchase
• 401k contribution

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