Supervisor, HEDIS Operations

Southfield, Michigan

This job has expired.


The Supervisor is responsible for planning, organizing, directing, implementing, and leading department assignments. This position operates within broad objectives to ensure optimum utilization of manpower and budget. This role oversees team and is responsible for completion of client HEDIS audits and medical record review processes. Coordinates projects and communications for internal senior management and client teams and supports future process and business improvement decisions.


  • Oversees and supports requirements related to the HEDIS Compliance Audit (Roadmap, onsite visit, medical record review validation, etc.).
  • Develops strategy and oversees execution of HEDIS medical record retrieval process to ensure high outcomes.
  • Manages and monitors multiple projects simultaneously by establishing project plans and objectives to ensure goal attainment within defined parameters.
  • Partner with Data and Analytics team to develop and monitor reports to support continuous improvement and improve client data sources.
  • Develops lines of communication to discuss/review results of HEDIS project to management via reports/presentations and assists management in implementing programs that provide solutions.
  • Investigates, reviews, recommends, communicates, and implements solutions which identify problems/root cause of issues.
  • Identifies and resolves challenges in order to fulfill key corporate objectives and responds to the demands of change management and initiates actions needed to plan, organize, and control team activities.
  • Independently develops and plans reports, papers, and/or other materials in a clear and concise manner.
  • Provides high level oversight and leadership.
  • Acts as liaison between corporate business areas and participates in group or committee discussions.
  • Recommends processes to control supply expenditures and promote efficient use of resources.
  • Participates in development of annual departmental budget, monitors budget and identifies budget discrepancies. Researches cause and makes recommendations.
  • Responsible for balancing workload to optimize the effectiveness of the department.

Directly supervises exempt and non-exempt staff in accordance with company policies and applicable Federal and State Laws. Responsibilities include, but are not limited to, effectively interviewing, hiring, terminating, and training employees; planning, assigning, and directing work; appraising performance; rewarding and counseling employees; addressing complaints and resolving problems; supporting and encouraging the engagement process.

This position description identifies the responsibilities and tasks typically associated with the performance of the position. Other relevant essential functions may be required.



Bachelor's degree in Business Administration, Economics, Health Care, Information Systems, Statistics, or a related field. Master's degree preferred. Relevant combination of education and experience may be considered in lieu of degree. Continuous learning, as defined by the Company's learning philosophy, is required. Certification or progress toward certification is highly preferred and encouraged.


Five years experience of progressive responsibility in a related environment with demonstrated technical knowledge that provides the necessary knowledge, skills, and abilities required One year of supervisory or leadership experience required.

  • Possesses and maintains an extensive comprehensive knowledge of business, products, programs (including provider data, networks, etc.), corporate organizational structure (including functional responsibilities), and basic research principles/methodologies.
  • Excellent analytical, planning, problem solving, verbal, and written skills to communicate complex ideas.
  • Knowledge of HEDIS guidelines and requirements.
  • Knowledge of products reported in HEDIS.
  • Ability to oversee and coordinate HEDIS medical record review functions.
  • Knowledge of medical record review reports and tools used to collect data during the medical record review timeframe.
  • Excellent knowledge and use of existing software packages (PowerPoint, Excel, Word, etc.).
  • Strong working knowledge of data languages such as SAS or SQL.
  • Ability to work independently, within a team environment and communicate effectively with employees at all levels.
  • Demonstrated mentoring and coaching experience
  • Must be self-motivated and work well under pressure.
  • Proficient in current industry standard PC applications and systems.
  • Must demonstrate leadership ability and team building skills to effectively supervise professional and non-professional staff and interact with all levels of management.
  • Ability to work with and empower others on a collaborative basis to ensure success of unit team.
  • Ability to effectively exchange information, in verbal or written form, by sharing ideas, reporting facts and other information, responding to questions, and employing active listening techniques.
  • Ability to effectively present budgetary and/or cost information and respond to questions as appropriate.
  • Ability to establish workflows, manage multiple projects, and meet necessary deadlines.

Work is performed in an office setting with no unusual hazards.

The qualifications listed above are intended to represent the minimum education, experience, skills, knowledge and ability levels associated with performing the duties and responsibilities contained in this job description.
We are an Equal Opportunity Employer. Diversity is valued, and we will not tolerate discrimination or harassment in any form. Candidates for the position stated above are hired on an \"at will\" basis. Nothing herein is intended to create a contract.

This job has expired.

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