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Core Competencies
Role fitCore Competencies
Use this summary to align your resume positioning with the role.
Demonstrates expertise in HEDIS data accuracy, quality improvement initiatives, and compliance with NCQA standards. Proven ability to manage projects, collaborate with healthcare providers, and analyze clinical quality metrics to enhance performance.
Highest-signal resume keywords
HEDIS Data AccuracyQuality Improvement InitiativesNCQA KnowledgeProject ManagementMS Office Suite Proficiency
ATS Keywords
Tailor your resumeApplicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills
HEDIS RequirementsQuality AuditsData AnalysisClinical Quality MetricsCompliance Controls
Soft Skills
CollaborationProblem-SolvingCommunication
Industry Keywords
Healthcare Quality ImprovementNational Committee on Quality AssuranceMember Compliance ReportsAtlanta, Georgia
About the role
Key responsibilities & impact- Perform duties to ensure HEDIS data accuracy and reporting
- Investigate, audit, and identify improvement opportunities
- Assist with quality improvement initiatives in service and clinical areas
- Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results
- Establish and maintain an action plan to improve HEDIS scores
- Request and evaluate member compliance reports for each HEDIS measure
- Collaborate with providers and internal departments on rate investigation and validation activities
- Maintain evidence, documentation, and changes
- Manage the HEDIS project, including nurse assignments, plan timelines, and vendor oversight
- Conduct quality audits and maintain data and process controls for compliance
- Perform other duties as assigned and comply with company policies and standards
Requirements
What you’ll need- Bachelors degree in related field or equivalent experience
- 3+ years of quality improvement or healthcare related experience
- Working knowledge of the National Committee on Quality Assurance (NCQA)
- HEDIS requirements preferred
- Proficiency with MS Office Suite
- Knowledge of quality improvement and HEDIS
- Ability to work fully remotely
- Must be based in Atlanta, Georgia, USA
Benefits
Comp & perks- Medical, dental & vision
- Critical Illness, Accident, and Hospital coverage
- 401(k) Retirement Plan with pre-tax and Roth post-tax contributions
- Voluntary Life & AD&D insurance for the employee and dependents
- Short- and long-term disability
- Health Spending Account (HSA)
- Transportation benefits
- Employee Assistance Program
- Time Off/Leave (PTO, Vacation or Sick Leave)