Job Purpose/Duties:
The HEDIS Manager will manage the HEDIS and CAHPS reporting project for Health Services for Children with Special Needs (HSCSN) and will work directly with the HSCSN management team, IT department, and external vendors to produce the required measurement and reports for annual HEDIS submission to NCQA and supports state reporting required Non-HEDIS quality management metric reporting as per CASSIP contract. In addition, the HEDIS Manager monitors HEDIS data collection, coordinates medical records review and outreach activities, identifies and audits medical records for gaps in care, and recommends ongoing improvements and maintenance.

Skills/Qualifications:
Bachelor's degree in a field of study relevant to health care management, public health or business administration; Master's degree preferred. Prior HEDIS project management is required. Three or more years experience in development and management of hybrid medical record retrieval process to support HEDIS reporting and five years experience in Medicaid and/or Medicare health care and insurance industry, including regulatory and compliance requirements. Five or more years clinical background preferred; Registered Nurse licensed in DC preferred. Previous supervisory experience required. Proficiency in software applications that include, but not limited to, Microsoft Word, Excel, PowerPoit, and Access. Excellent verbal and written communication skills with ability to speak clearly and concisely, conveying complex or technical information as well as ability to understand and interpret complex information required.

Health Services for Children with Special Needs, Inc. (HSCSN) is an innovative care management network coordinating health, social, and education services for the pediatric Supplemental Security Income (SSI) and SSI-eligible populations of Washington, DC.  We offer competitive a salary and benefits which include health, dental, life insurance, tuition assistance, 403b and flexible spending accounts.  EOE