UCare

HEDIS Supervisor

7 days left

Employer
UCare
Location
Minneapolis, Minnesota
Posted
Jul 29, 2022
Closes
Aug 23, 2022
Ref
3103
Category
Healthcare
Employment Status
Full Time
Health Care that Starts with You!

Join a truly mission-driven organization! Independent, nonprofit UCare is recognized as one of the Minnesota's leading health plans. We provide more than 600,000 members across Minnesota and western Wisconsin with the health coverage plans and services they need to maintain and improve their health. The innovative coverage we create makes a difference for Medicare-eligible individuals, individuals and families enrolled in Minnesota Health Care Programs, such as MinnesotaCare and Medical Assistance, and disabled adults with special health care needs.

UCare is growing in size, membership, products, geographic coverage, and employees. We're an organization that's going places. Be part of a team that cares about you, be part of UCare.

Rewards

Enter a highly collaborative environment where people are truly engaged, and feedback is valued. You'll enjoy a competitive salary and benefits, as well as a host of other perks, including a nationally recognized wellness program, and a bright, open, award-winning office space in Northeast Minneapolis just minutes from major freeways and retail centers.

At UCare, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

www.ucare.org/careers/

EOE/AA

ABOUT UCARE

UCare offers Medicare, Medicaid, Individual and Family health plans - powered by the hardest working people in the industry. Our people powered teams de-complicate, advocate and always go the extra mile to help our members. We serve with integrity, compassion and commitment to do right by members, providers and government partners. Above all, we come to work excited to provide members a path for the best health of their lives.

WORKING AT UCARE

Working at UCare is more than a career; it's a mission. A mission that defines us as professionals, unites us as an organization and shapes how we interact with our members and each other. Employees join UCare and stay because of the opportunity to have a purpose-driven job.

Our strong culture has established UCare as a Star Tribune Top 200 Workplace for 13 consecutive years since the awards program began. It's a culture that embraces innovative ideas, strategic partnerships, and exemplary customer and provider experiences. Working at UCare is being a part of a people powered team dedicated to making a real difference in the lives of our members and communities.

HEDIS SUPERVISOR

Work Location: Work from home or hybrid (in the office 3 or more days per week)

The health and safety of our employees, members, providers, and our community is our highest priority. Therefore, all new employees are expected to be fully vaccinated against COVID-19 prior to starting at UCare, subject to limited exceptions such as for a sincerely held religious belief or for medical reasons.

Position Description

This position is responsible for providing leadership and direction within the HEDIS team of Quality Improvement (QI) to ensure the annual HEDIS submissions are delivered according to NCQA technical specifications and deadlines, while simultaneously supporting the organization's efforts to achieve the highest ratings on HEDIS measures.

As the HEDIS Supervisor, you will oversee all temporary Quality Review Specialists that support the chart retrieval and abstraction process. In addition, you will onboard all new staff, provide training and education on HEDIS technical specifications according to UCare's HEDIS manual, triage and answer questions during the season, and ensure staff are in compliance with reporting on HEDIS results.

This position will also assist the HEDIS Manager with projects that include a wide array of business activities such as evaluation, planning, and/or implementation of process improvement initiatives that enhance the organization's medical record review functionality for HEDIS hybrid measures and other QI needs. This leadership position will actively strive to foster an organizational culture that is based on collaboration, partnership, innovation, customer service, driving change, flexibility, teamwork, and continuous quality improvement.

• Serve as a subject matter expert for Supplemental and Hybrid data entry and Primary Source Verifications (PSV) for Quality Review Specialists, provide daily direction and assistance with staff questions.

• Assists with the coordination of HEDIS and STARs data gathering processes whether through EMRs or other applications.

• Supports the HEDIS Manager with communication to the HEDIS team on work prioritization, best practices, and changes to strategy.

• Interview, onboard and support annually the temporary Quality Review Specialists, which includes delegation of work activities, coaching, mentoring, goal setting and project management guidance.

• Evaluate the completeness and accuracy of clinical documentation processes by performing medical record reviews and quality assurance overreads, directing the overread priorities, assessing adherence to the HEDIS Technical Specifications and analyzing any documentation deficits.

• Conduct training for temporary staff on hybrid measures and all staff on data abstraction tools and software, including maintaining training aids and resources.

• Assist HEDIS Manager in key workflow design for the hybrid data software system for optimal results and efficiency.

• Pull, review and report out on quality and productivity reports for the HEDIS process.

• Support chart chase efforts by requesting medical records from providers, as needed.

• Investigate, review, recommend, communicate, and implement solutions which identify problems/root cause of issues. Communicate to the HEDIS Manager as needed.

• Collaborate with internal and external entities, including the provider network and Health Care Economics.

• Coordinate and support the following activities as dictated by each initiative or project (as needed): data analysis, business requirement development, project, and process improvement facilitation.

• Acquire and maintain knowledge of industry practices, trends, and methodologies through readings, networking, and attending seminars.

• Other projects and duties as assigned.

Education

Bachelor's Degree in Business Administration, Health Care, Nursing, Information Systems, Public Health, Social Sciences, or other closely related field. Demonstrated experience may be considered in lieu of degree.

Required Experience

At least three years' experience in a health-related field, preferably in a health care industry setting. Familiar with health care metrics and process improvement experience. Proficient in Microsoft Office. At least two years' HEDIS (Health Effectiveness Data and Information Set) experience and knowledge specifically with chart review operations. At least one year of supervisory experience.

Preferred Experience

Detailed experience in and/or knowledge of HEDIS reporting process and quality reporting. Database knowledge and development. Claims systems and/or electronic medical records. Clinical documentation and coding knowledge. Software vendor and HEDIS auditor relationship experience.

THE UCARE DIFFERENCE

The UCare difference is our people power - employees actively working on the behalf of our members to get them access to the health care they need. We value and respect each individual's ideas and contributions, and provide the freedom to grow both personally and professionally. We are centrally located, and offer onsite education, equipment and wellness resources, and a myriad of volunteer activities. If you're looking for an inclusive environment that celebrates your people power, helps you build on your strengths and gives you the opportunity to truly make a difference, we invite you to apply.

As an Equal Opportunity/Affirmative Action Employer, we welcome and employ a diverse employee group committed to meeting the needs of UCare, our members, and the communities we serve.

JOB POST DATE: 07/28/2022

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