Job Information
Corewell Health HEDIS Operations Specialist in Grand Rapids, Michigan
Job Summary
Join Corewell Health as a HEDIS Operations Specialist and play a pivotal role in elevating our health plan ratings and making the Corewell Health health plan shine! In this essential position, you'll take the lead in coordinating and delivering critical milestones to ensure we meet NCQA HEDIS standards. Partnering closely with our HEDIS vendor, you'll oversee data runs, manage updates with technical teams, and orchestrate the annual HEDIS audit. As the driving force behind the annual HEDIS hybrid season, you'll also coordinate assignments for nurse abstractors and facilitate key processes. Ideal candidates will be self-directed, project focused, and exceptionally organized - bringing a proactive mindset that enhances quality and value for our health plan members. Step into a role where your contribution directly impacts the success of Corewell Health!
Essential Functions
Provides operational support for new and existing programs and projects. Ensures required documentation, reporting, data collection and database utilization are performed in an accurate and timely manner. Prepares progress reports, study results and other reports as required.
Collects and analyzes process, productivity, value and quality related data to initiate, develop, and recommend operational practices and procedures that focus on operational efficiency, enhanced safety, increased productivity, and reduced cost.
Engages in process and quality improvement initiatives. Responsible for implementing recommendations to improve operational efficiency, new services for area of responsibility and creates documentation of new established workflows.
Serves as the operational lead to provide structure, project management and direction for new and existing workflow transformation and other operational initiatives. Collaborates with leadership to develop action and projects plans focused on operations and running the business.
Assists with the coordination of compliance activities to ensure services are provided in accordance with State and Federal regulations, organizational policies and procedures, medical staff bylaws and accreditation/compliance requirements.
Daily stand up with Developers and Data Engineers.
May serve as interim leadership.
How Corewell Health cares for you
Comprehensive benefits package to meet your financial, health, and work/life balance goals. Learn more here (https://careers.corewellhealth.org/us/en/benefits-new) .
On-demand pay program powered by Payactive.
Discounts directory with deals on the things that matter to you, like restaurants, phone plans, spas, and more!
Optional identity theft protection, home and auto insurance, pet insurance.
Traditional and Roth retirement options with service contribution and match savings.
Qualifications
Required
Bachelor's Degree or equivalent in business, healthcare administration or related field
3 years of relevant experience related to leadership
Preferred
- Experience in healthcare and working within in an organization of size and complexity comparable to Corewell Health
About Corewell Health
As a team member at Corewell Health, you will play an essential role in delivering personalized health care to our patients, members and our communities. We are committed to cultivating and investing in YOU. Our top-notch teams are comprised of collaborators, leaders and innovators that continue to build on one shared mission statement - to improve health, instill humanity and inspire hope. Join a nationally recognized health system with an ambitious vision of continued advancement and excellence.
Primary Location
SITE - Priority Health - 1239 E Beltline - Grand Rapids
Department Name
PH - HEDIS
Employment Type
Full time
Shift
Day (United States of America)
Weekly Scheduled Hours
40
Hours of Work
8 a.m. to 5 p.m.
Days Worked
Monday to Friday
Weekend Frequency
N/A
CURRENT COREWELL HEALTH TEAM MEMBERS – Please apply through Find Jobs from your Workday team member account. This career site is for Non-Corewell Health team members only.
Corewell Health is committed to providing a safe environment for our team members, patients, visitors, and community. We require a drug-free workplace and require team members to comply with the MMR, Varicella, Tdap, and Influenza vaccine requirement if in an on-site or hybrid workplace category. We are committed to supporting prospective team members who require reasonable accommodations to participate in the job application process, to perform the essential functions of a job, or to enjoy equal benefits and privileges of employment due to a disability, pregnancy, or sincerely held religious belief.
Corewell Health grants equal employment opportunity to all qualified persons without regard to race, color, national origin, sex, disability, age, religion, genetic information, marital status, height, weight, gender, pregnancy, sexual orientation, gender identity or expression, veteran status, or any other legally protected category.
An interconnected, collaborative culture where all are encouraged to bring their whole selves to work, is vital to the health of our organization. As a health system, we advocate for equity as we care for our patients, our communities, and each other. From workshops that develop cultural intelligence, to our inclusion resource groups for people to find community and empowerment at work, we are dedicated to ongoing resources that advance our values of diversity, equity, and inclusion in all that we do. We invite those that share in our commitment to join our team.
You may request assistance in completing the application process by calling 616.486.7447.
