North Carolina Licensed HEDIS Analyst

Job Summary

To provide clinical direction and quality oversight for HEDIS-related activities, the full-time North Carolina Licensed HEDIS Analyst will manage data collection, quality improvement initiatives, and compliance with NCQA standards while working remotely with occasional in-office meetings.

Key responsibilities

• Oversee HEDIS projects, ensuring alignment with NCQA measures and quality assurance processes
• Generate and analyze HEDIS quality reports, coordinating quality management programs to ensure regulatory compliance
• Develop training materials and conduct training sessions for staff on HEDIS measures and quality improvement practices

Required qualifications

• Graduation from an accredited nursing program with an RN or LPN license and five years of healthcare experience in HEDIS clinical quality
• Experience with NCQA Technical Specifications and medical record abstraction related to HEDIS audits
• Knowledge of operational requirements for HEDIS data collection and reporting
• Experience working with the Medicaid population in relation to HEDIS measures
• Certification as a Professional in Healthcare Quality (CPHQ) is preferred