Risk Adjustment-HEDIS Analyst - Community Health Choice
Harris Health System
Location: Houston, Texas
Type: Full Time
Internal Number: 156695
The Risk Adjustment & HEDIS Analyst will utilize and evaluate claims, authorization, member and provider data to assist the Director, Quality Validation to develop, track and monitor healthcare quality metrics, cost and make recommendations to support business decisions. The Risk Adjustment & HEDIS Analyst will exhibit familiarity with using data from various relational databases. The Risk Adjustment & HEDIS Analyst generates departmental performance reports, validates results and makes recommendation on how to interpret information.
Bachelor's Degree in Business. Public Health, Mathematics or related field.
Master degree, MBA or MHA preferred.
Two years of work experience in Analytics, reporting, Business Intelligence or related area preferred.
Two years in Healthcare and experience working on HEDIS is highly preferred.
Experience working on Commercial Risk Adjustment and HEDIS
Experience with SQL query writing and using reporting tools (e.g. MS Excel, SQL Reporting Services, Power BI etc.).
Basic Medical knowledge of ICD9 and ICD10 codes. .
Knowledge of data analysis methodology, understanding of data analytic tools and good communication and documentation skills.
Experience developing actionable reporting using key metrics communicated in an easy to understand manner.
Writing /Composing: Correspondence /Reports
Analytical, Mathematics, Medical Terminology
Please be advised: Effective Wednesday, September 1st, 2021, with the exception of those who receive an approved exemption, all new hires must provide proof of vaccination against COVID-19 or receive the first dose of a COVID-19 vaccine by the second Friday of employment.
The Harris Health System is a fully integrated healthcare system that cares for all residents of Harris County, Texas. We are the first accredited healthcare institution in Harris County to be designated by the National Committee for Quality Assurance as a Patient-Centered Medical Home, and are one of the largest systems in the country to achieve the quality standard. Our system includes 23 community health centers, five school-based clinics, a dental center and dialysis center, mobile health units, a rehabilitation and specialty hospital and two full-service hospitals.Ben Taub Hospital is a world renowned Level I Trauma Center with 586 licensed acute-care beds and provides a wide range of specialty care outpatient services. Lyndon B. Johnson Hospital is a 328 licensed bed acute-care hospital with a newly expanded Level III trauma center and a distinguished regional center for neonatal intensive care for high-risk deliveries.Harris Health is a teaching system for Baylor College of Medicine and The University of Texas Health Science Center at Houston (UTHealth). We train the next generation of healthcare providers on the latest medical procedures and technological breakthroughs.With... our fully integrated electronic medical records system, we offer patients the convenience and assurance that their medical history is accurate, safe and available when and where it is needed. Our Medical Home designation ensures that we offer a full range of preventive, specialty and acute care services for the entire family.