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Senior Analyst, HEDIS Data and Reporting (Telework) (68557BR)

Primary Location: Phoenix, AZ
Additional Locations: AZ-Phoenix
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Description:
Come and join the National Medicaid Quality Data Team supporting nationwide Medicaid HEDIS!

Our Senior Analyst, HEDIS Data & Reporting will be responsible for conducting highly complex quality management, procedural documentation, and/or special analysis on key HEDIS data sets across all of the Aetna Medicaid state health plans.

Opportunity can be virtual / work from home from anywhere in the U.S.

Fundamental Components:
(*) Serves as subject matter expert in Quality Management, auditing practices, financial calculations, benefits, systems, external audits, internal audits, and internal controls.

(*) Mentors other analysts on the team.


(*) Functional understanding of NCQA and HEDIS quality measures.

(*) Proficient in SQL queries and data management of HEDIS data by gaining knowledge of the HEDIS value set directories, QNXT data sets, and technical specifications in the creation of the annual HEDIS extracts for annual NCQA & state reporting.

(*) Work on providing reports and queries back to multiple HEDIS auditors.

(*) Help in the next generation of HEDIS reporting using ECDS standards.

(*) Daily management of incoming requests from the health plan regarding HEDIS rates and data.


(*) Contribute to streamlining the annual and monthly HEDIS project tasks as it relates to analysis and reporting.

Background Experience:
(*) Must have significant advanced SQL experience within Quality or Healthcare field.

(*) Minimum of 5-8 years of experience working with data sets or related functional business experience, preferably within healthcare IT portion of the health insurance domain, demonstrating high proficiency in the competencies noted.

(*) Experience using HEDIS engine software.


(*) Bachelor’s Degree in Public Health, Health Care Informatics, Risk Management, Insurance, or related field of study or equivalent experience preferred.



Additional Job Information:
Day to Day responsibilities include:
- analyzing plan requests for measure issues
- reviewing data sets for completeness
- complex queries for reporting requests
- issue analysis and resolution
- strategic planning for Digital Measures solutions and reporting
- Code reviews from BIS - ETL Counterparts
- Mentoring of Staff
-


Required Skills:
Technology - Leveraging Technology, Technology - Promoting Emerging Technology, Technology - Selecting and Applying Technology Solutions

Desired Skills:
General Business - Applying Reasoned Judgment, General Business - Communicating for Impact, General Business - Demonstrating Business and Industry Acumen

Functional Skills:
Information Management - Business information analysis, Information Management - Query and Database Access Tools

Potential Telework Position:
Yes

Percent of Travel Required:
0 - 10%

EEO Statement:
Aetna is an Equal Opportunity, Affirmative Action Employer

Benefit Eligibility:
Benefit eligibility may vary by position.

Candidate Privacy Information:
Aetna takes our candidate's data privacy seriously. At no time will any Aetna recruiter or employee request any financial or personal information (Social Security Number, Credit card information for direct deposit, etc.) from you via e-mail. Any requests for information will be discussed prior and will be conducted through a secure website provided by the recruiter. Should you be asked for such information, please notify us immediately.

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