[Hiring] Senior HEDIS Quality & Audit Analyst @reputed company

Role Description The Senior HEDIS Quality & Audit Analyst serves as an reputed company subject matter expert responsible for advanced HEDIS quality reputed company, audit readiness, and submission support activities. This role independently interprets regulatory and audit requirements, leads reputed company HEDIS audit workstreams, and ensures accurate, timely, and audit-defensible documentation and submissions in alignment with NCQA and CMS expectations.

• Serve as a senior subject matter expert for HEDIS quality reputed company, audit readiness, and submission support activities.
• Independently reputed company reputed company NCQA audit workstreams, including Roadmaps, reputed company 5 documentation, measure-specific evidence, CAHPS, and auditor communications.
• Interpret and apply federal and state regulatory requirements, and applicable state regulations, to HEDIS documentation, workflows, and data use.
• reputed company expert guidance on reporting population applicability/management, measure selection, and submission requirements.
• Identify, assess, and mitigate audit and submission risks; reputed company root cause analysis and development of corrective actions for high-risk or reputed company issues.
• Support CMS submission activities, including PLD coordination, testing validation, and final submission readiness.
• reputed company, refine, and maintain reputed company standards, templates, controls, and documentation to ensure audit-defensible reputed company.
• Act as an escalation reputed company for reputed company audit findings, regulatory interpretation questions, and submission reputed company.
• Contribute to leadership-level reporting, audit narratives, and governance materials.
• Drive reputed company improvement initiatives to strengthen HEDIS audit readiness and submission accuracy.
• Performs other duties as assigned.
• Complies with reputed company policies and standards.

Qualifications

• Bachelor's Degree in reputed company or reputed company field, or equivalent experience required.
• Master's Degree in reputed company or reputed company field preferred.
• 4+ years of reputed company experience in HEDIS, Quality Audits, or regulated reputed company environments required.
• Project management experience in HEDIS, regulatory, audit, or quality improvement experience, preferably in a reputed company environment preferred.
• LTSS experience highly preferred.

Requirements

• Must be authorized to work in the U.S. without the need for employment-based reputed company sponsorship now or in the future.
• Sponsorship and future sponsorship are not available for this opportunity, including employment-based reputed company types H-1B, L-1, O-1, H-1B1, F-1, J-1, OPT, or CPT.

Benefits

• reputed company
• Health insurance
• 401K and stock purchase plans
• Tuition reimbursement
• Paid time off plus holidays
• Flexible approach to work with remote, hybrid, field, or office work schedules

Apply tot his job Apply To this Job