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Director Hedis Analyst Jobs in Indiana (NOW HIRING)

STI

ADDM Abstractor

Indianapolis, IN · On-site +1

... Direct Reports: There are no supervisory responsibilities to this position. Difficulty of Work: The work is broad in scope, involving complex issues that require analytical, decision-making, and ...

STI

ADDM Abstractor

Indianapolis, IN · On-site +1

... Direct Reports: There are no supervisory responsibilities to this position. Difficulty of Work: The work is broad in scope, involving complex issues that require analytical, decision-making, and ...

STI

ADDM Abstractor

Indianapolis, IN · On-site

... Direct Reports: There are no supervisory responsibilities to this position. Difficulty of Work: The work is broad in scope, involving complex issues that require analytical, decision-making, and ...

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Director Hedis Analyst information

What is a Director HEDIS Analyst?

Director HEDIS Analysts are senior professionals responsible for overseeing the Healthcare Effectiveness Data and Information Set (HEDIS) programs within healthcare organizations. They manage teams that collect, analyze, and report quality performance data to ensure compliance with regulatory standards and improve patient care. Their role often includes developing strategies to enhance HEDIS measure outcomes, collaborating with clinical and IT departments, and ensuring accurate data submission to accrediting bodies. Directors also stay updated on changing HEDIS requirements and work to implement best practices throughout their organization.

How does a Director HEDIS Analyst typically collaborate with clinical and IT teams to improve data quality and reporting?

A Director HEDIS Analyst often serves as a bridge between clinical, IT, and quality improvement teams to ensure accurate and timely data collection and reporting for HEDIS measures. They coordinate with IT to optimize data extraction from electronic health records, and work closely with clinicians to clarify documentation requirements and address data gaps. Regular meetings, cross-functional training sessions, and collaborative problem-solving are common, fostering a team environment focused on continuous improvement in data quality and compliance.

What are the key skills and qualifications needed to thrive as a Director HEDIS Analyst, and why are they important?

To thrive as a Director HEDIS Analyst, you need expertise in healthcare data analysis, quality measurement, and a strong understanding of HEDIS metrics, often supported by a degree in health informatics, public health, or a related field. Experience with analytic tools such as SAS, SQL, and healthcare data platforms, along with knowledge of NCQA regulations and HEDIS reporting systems, is crucial. Outstanding leadership, problem-solving, and communication skills help drive quality initiatives and manage cross-functional teams. These skills are essential to ensure accurate reporting, regulatory compliance, and continuous improvement of healthcare quality outcomes.

What is the difference between Director Hedis Analyst vs Hedis Analyst?

AspectDirector Hedis AnalystHedis Analyst
Required CredentialsBachelor's degree, possibly advanced certifications in healthcare or analyticsBachelor's degree in healthcare, statistics, or related field
Work EnvironmentLeadership role overseeing teams, strategic planningData analysis, reporting, and compliance tasks
Employer & Industry UsageHealthcare organizations, insurance companiesHealthcare providers, insurance companies, analytics firms
Common Search & ComparisonHigher-level responsibilities, management focusData-focused, operational role

The main difference between a Director Hedis Analyst and a Hedis Analyst lies in their level of responsibility. The Director Hedis Analyst typically oversees teams and strategic initiatives, requiring leadership skills and possibly advanced certifications. In contrast, the Hedis Analyst focuses on data analysis and compliance tasks. Both roles are vital in healthcare analytics but differ in scope and seniority.

What are the most commonly searched types of Hedis Analyst jobs in Indiana?

The most popular types of Hedis Analyst jobs in Indiana are:

What are popular job titles related to Director Hedis Analyst jobs in Indiana?

For Director Hedis Analyst jobs in Indiana, the most frequently searched job titles are:

What job categories do people searching Director Hedis Analyst jobs in Indiana look for?

The top searched job categories for Director Hedis Analyst jobs in Indiana are:

What cities in Indiana are hiring for Director Hedis Analyst jobs?

Cities in Indiana with the most Director Hedis Analyst job openings:

Director Hedis Analyst jobs near you

Clinical Quality Specialist

Indianapolis, IN

SIHO Insurance Services
Insurance Services • 51 - 200 employees
Learn more about SIHO Insurance Servicesexternal

$35 - $46.50/hr

Full-time

Re-posted 6 days ago

Job description

Job Title: Clinical Quality Specialist

Reports to: Director, Medical Management

The Clinical Quality Specialist supports the Clinical Quality Nurse in overseeing the HEDIS quality collection, submission, reporting, and auditing as well as assists with education to support the MyTruAdvantage line of business.

 

Key Responsibilities:

 

  • Knowledge of current HEDIS guidance, hybrid measure reporting, and measure compliance requirements.
  • Collaborate with Clinical Quality Nurse and internal data analyst to oversee HEDIS quality gap distribution to health partners and member providers for HEDIS clinical data collection.
  • Participate in communication with health partners regarding process of clinical document submission, annual education on applicable HEDIS measures, and cadence of reporting.
  • Help identify opportunities for improved or expanded HEDIS data collection.
  • Participate in internal chart chasing efforts.
  • Assure proper internal secure storage of HEDIS data collected from external providers.
  • Participate in Medical Record Review clinical submissions processes, assuring accuracy and completeness.
  • Support outreach efforts to external providers to collect clinicals needed for reporting.
  • Assist with maintaining all HEDIS related guidelines, policy & procedures, and auditing documents necessary for successful annual HEDIS audits.
  • Active participant in any external HEDIS audits performed as needed.
  • Support internal Chronic Care Improvement Program initiatives as needed.
  • Participate in internal or external process improvement efforts that support the quality improvement and collection efforts necessary for the Medicare Advantage or commercial lines of business. (Accurate provider attributions, training of health partners, training of new internal staff etc.)

Minimum Skills Requirement:

  • CMA or experience in clinical documentation review preferred.
  • Experience in working for or with HEDIS data collection and reporting preferred.
  • Proficiency in Microsoft Office Suite (Outlook, Word, Excel, PowerPoint).
  • Experience with electronic medical records and using online tools.
  • Ability to communicate professionally with physicians and office staff to facilitate organizational initiatives.
  • Willingness to obtain applicable HEDIS certifications deemed appropriate for position.

We may use artificial intelligence (AI) tools to support parts of the hiring process, such as reviewing applications, analyzing resumes, or assessing responses and identifying potential inconsistencies or verification signals in application materials based on available information. These tools assist our recruitment team but do not replace human judgment. Final hiring decisions are ultimately made by humans. If you would like more information about how your data is processed, please contact us.