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Job Summary

FEP HEDIS Analyst Responsibilities:

Run FEP reporting for CM/CM teams-Including prioritization and filtering. Run FEP HEDIS Reporting for meetings and prioritization. Submission of HEDIS data from internal sources to the BCBSA via traditional SFTP/email/etc.
Prepare Power BI reporting for HEDIS Measures
Become a liaison between the MA/ACA/FEP HEDIS teams for collaborated ideas
Become a liaison between the Health Data Management and FEP HEDIS teams

Requirements

EDUCATION

Bachelor’s degree in Science, Technology, Math, Business, Data Science/Informatics, Actuarial Science, Healthcare Management, or other related field. In lieu of degree, five (5) years' health-related, non-clerical experience with an insurance, managed care, or healthcare technology-related organization will be considered.

EXPERIENCE

Minimum three (3) years' data analytics experience, which includes data extraction, data manipulation, repository building and data interpretation. OR applicable Masters in related field with minimum one (1) years' data analytics experience.

Experience with rational database i.e. SAS, SQL, AQT and MS Windows based query software.

Experience with the application of data management and analysis tools including but not limited to MS Access, SAS, R, S+, SQL, or Cognos preferred.

ESSENTIAL SKILLS & ABILITIES

Process Information

Deductive Reasoning

Category Flexibility

Case-Based Reasoning

Problem Solving

Report Creation

Report Processing

Report Presentations

Objectives Oriented

Strategic Approach

Critical Thinking

Organizing

Prioritization

Planning Activities

MySQL

IBM Cognos Impromptu

Mathematical Reasoning

Problem Sensitivity

Interpersonal Communication

Applied Research

External Communication

Sound Judgment

Decision Making

Written Expression

Written Comprehension

Information Collection

Analyze Information

Skills

• Analytical Decision Making
• Analytical Problem Solving
• Collaborative Communications
• Critical Reasoning
• Critical Thinking
• Cross-Functional Communications
• Cross-Functional Planning
• Data Analysis
• Database Queries
• Data Management
• Deductive Reasoning
• IBM Cognos Impromptu
• Information Interpretation
• Management Techniques
• Mathematical Reasoning
• MySQL Database Administration
• Object Classification
• Problem Sensitivity
• Researching
• Security Awareness
• Sound Judgment
• Strategic Planning
• Written Communication

Responsibilities

• Consults with users or decision makers to identify data sources, required data elements, and/or data validation standards.
• Integrates data from multiple data sources or functional areas, ensures data accuracy and integrity, and updates data as needed to develop statistics and design methodologies to be used for decision making and new business initiatives.
• Interprets data to identify business trends, conduct root cause analysis of business problems, and suggest areas for process improvement.
• Manages and uses ad-hoc report requests and findings to develop reporting processes.
• Serves on special projects.

Certifications

Security Requirements

This position is identified as level three (3). This position must ensure the security and confidentiality of records and information to prevent substantial harm, embarrassment, inconvenience, or unfairness to any individual on whom information is maintained. The integrity of information must be maintained as outlined in the company Administrative Manual.

Segregation of Duties

Segregation of duties will be used to ensure that errors or irregularities are prevented or detected on a timely basis by employees in the normal course of business. This position must adhere to the segregation of duties guidelines in the Administrative Manual.

Employment Type

Regular

ADA Requirements

2.1 General Office Worker, Semi-Active, Campus Travel - Someone who normally works in an office setting or remotely, periodically has lifting and carrying requirements up to 40 lbs and routinely travels for work within walking distance of location of primary work assignment as essential functions of the job.