HEDIS Analyst

G.E.H.A (Government Employees Health Association, Inc.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

G.E.H.A has one mission: To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, G.E.H.A empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization. 

The HEDIS (Healthcare Effectiveness Data and Information Set) Analyst leverage governed and ungoverned datasets to drive HEDIS outcomes. This position requires knowledge in HEDIS metrics and analytics to manage the HEDIS lifecycle, develop actionable insights, and ensure data accuracy and compliance. The HEDIS Analyst will be support the business leveraging prior experience and knowledge to gather business requirements and implement solutions to drive HEDIS Outcomes. The opportunity involves independent and collaborative work with team members to achieve results through projects and ad-hoc development.

SKILLS

Duties & Responsibilities

• Leverage HEDIS platform to ensure proper submission HEDIS results and audits.
• Partnering with business to gather requirements for analytical reporting and analysis 
• Maintain and update HEDIS-based reports to support quality initiatives and represent the HEDIS team in internal collaborations.
• Assist as necessary in the review of medical records.
• Develop and ensure adherence to data standards and processes to drive business outcomes with high level of quality and accuracy
• Actively participate in identifying and implementing process improvements and enhancements to analytical methodologies and tools.
• Collaboration with internal departments for HEDIS improvement
• Assists as necessary in the HEDIS Road Map and all other documents required by auditors.
• Adhere to Data Governance standards and ensure that all data is handled in accordance with HIPAA, departmental and corporate guidelines to safeguard privacy and confidentiality, applying appropriate techniques to mask and encrypt data when necessary
• Foster team culture to promote strong documentation writing. 
• Other Duties as assigned

Knowledge, Skills & Abilities

• Bachelor’s degree in Healthcare, Business Administration, Computer Science, Statistics or a related discipline. Experience will be considered in lieu of education.
• 2+ years of experience in healthcare and/or managed care
• 2+ years of HEDIS experience
• Experience with SQL and PowerBI or equivalent tools (Tableau, Cognos, MicroStrategy)
• Knowledge of data warehousing concepts and technologies to support effective data management and reporting.
• PL300 certification or equivalent 
• Strong written and oral communication skills.
• Demonstrated ability to approach complex business problems analytically and develop actionable solutions based on data insights.
• High attention to detail to ensure the accuracy and consistency of data and reports.

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.
• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.
• Latency (ping) response time lower than 80 ms
• Hotspots, satellite and wireless internet service is NOT allowed for this role.
• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges
• Incentive plan
• Health/Vision/Dental benefits effective day one
• 401(k) retirement plan:  company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution   
• Robust employee well-being program
• Paid Time Off
• Personal Community Enrichment Time
• Company-provided Basic Life and AD&D
• Company-provided Short-Term & Long-Term Disability
• Tuition Assistance Program

While this is a remote opportunity, at this time G.E.H.A does not hire employees from U.S. territories or the following states: Alaska, Hawaii, California, Washington, Oregon, Colorado, Wyoming, Montana, New York, Connecticut, Vermont, Pennsylvania, Maine.

Please note that the salary information is a general guideline only.  G.E.H.A considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The hiring range for this position is $75,862 - $95,970 USD. At G.E.H.A, the current maximum salary for this role is $106,938 USD. While initial compensation may vary based on experience and qualifications, there is a path to work toward this top rate through performance and continued growth within the organization.

G.E.H.A is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. G.E.H.A will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

G.E.H.A is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.