Lumeris Supervisor, HEDIS in St. Louis, Missouri

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Position:

Supervisor, HEDIS

Position Summary:

The HEDIS Supervisor will be responsible for overseeing the daily operations of the HEDIS/Star analytics team within the Quality Improvement department at Lumeris. Provides guidance for complex analytics and reporting in support of the annual HEDIS submission, Medicare Star program, NCQA accreditation, and regulatory and contractual compliance. Coaches, mentors and leads team to ensure timely and accurate reporting to meet accreditation, regulatory requirements and performance measure targets.

Job Description:

Role and Responsibilities:

  • Serves as a subject matter expert on HEDIS measures and the annual HEDIS process, as well as the Medicare Star program and annual rating process

  • Determines the resources and participants needed to achieve goals.

  • Builds and develops collaborative relationships vital to the success of programs.

  • Delegates tasks and responsibilities to manage dependencies and critical path resulting in program activities completed on time and within budget.

  • May be responsible for concurrent and/or retrospective review, data abstraction, analysis, identification of critical issues, process improvement support, required education, and assisting with measurement of performance metrics.

Experience, Qualifications and Education:

  • Bachelor degree preferred but will accept less in lieu of experience

  • 2-3 Years HEDIS program experience required

  • Knowledge of Quality Management Programs

  • Knowledge of NCQA URAC accreditation and certification

  • 2+ years Medicare Medicaid or commercial health plan experience required

  • Strong written and communication skills with the ability to write clear, structured, articulate, and persuasive proposal responses

  • Strong editing skills with attention to detail and ability to meet deadlines

  • Experience working in deadline-driven environments

  • Able to work well in a team environment, handle multiple tasks, and meet deadlines

  • High level initiative, problem solving, and collaboration abilities

  • Able to effectively coordinate efforts across different organizational departments and also with external organizations

  • Able to monitor and meet program goals

  • Proficient in use of Microsoft Office Suite and use of the Internet

Lumeris is an EEO/AA employer M/F/V/D.

Location:

St. Louis, MO

Time Type:

Full time

Status:

XL - FT

Join Our Growing Team!

Lumeris serves as a long-term operating partner for organizations that are committed to the transition from volume- to value-based care and delivering extraordinary clinical and financial outcomes. Lumeris enables clients to profitably achieve greater results through proven playbooks based on collaboration, transparent data and innovative engagement methodologies. Lumeris offers comprehensive services for managing all types of populations, including launching new Medicare Advantage Health Plans, Commercial and Government Health Plan Optimization, and Multi-Payer, Multi-Population Health Services Organizations (PHSOs). Currently, Lumeris is engaged with health systems, provider alliances and payers representing tens of millions of lives moving to value-based care.

Over the past seven years, we have tripled in size to more than 800 employees and built the only solution on the market with our proven outcomes. For the past six years, Essence Healthcare, a long-standing Lumeris client, has received 4.5 Stars or higher from the Centers for Medicare and Medicaid Services (CMS). Essence Healthcare was Lumeris’ pioneer client and has been leveraging Lumeris for more than a decade to operate its Medicare Advantage plans, which serve more than 60,000 Medicare beneficiaries in various counties throughout Missouri and southern Illinois.

In 2018, Lumeris was named Best in KLAS for Value-Based Care Managed Services in the area of client-reported impact on the Triple Aim by KLAS Research. This was the third year in a row Lumeris received the award, and it has only been given for three years. As the industry’s most reliable and effective partner for developing population health management solutions, our success is driving tremendous growth in our company. Join us today in making a real difference in how healthcare is delivered!

Why Join Lumeris?

At Lumeris, you will be part of team that is focused on solving the nation’s healthcare problem, and you will be able to contribute to our purpose. Our environment is fast-paced, change-oriented and focused on growth and employee engagement. At Lumeris, we know that talent is best utilized when given the opportunity to succeed. That is why we have removed the boundaries that inhibit success and focus on fostering an environment that allows employees to utilize their talents.