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GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. We celebrate diversity and are committed to creating an inclusive environment for all employees.

GEHA has one mission: To empower federal workers to be healthy and well.

Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. We serve our members with products they value and a personalized customer experience, sustained by a nimble and efficient organization.

Establishes business rules for accurate use of HEDIS (HealthCare Effectiveness Data and Information Set) reporting data fields. Generates and maintains thorough and accurate documentation related to data, databases, business rules, and reporting policies and procedures.

Develops and executes test processes related to end-user data and databases; documents and tracks data-related issues and facilitates resolution of such issues.

Supports identification of training opportunities and assist in mentoring and training associates in regards to HEDIS. Position interacts with associates at all levels in the organization, external clients and vendors

SKILLS

• Manage the HEDIS lifecycle process for multiple plans.

• Responsible for assuring the accuracy and validity of both source data and results and interpreting results into recommendations.

• Develops and implements data-driven solutions to meet business requirements by producing analytics, reports, and data sets.

• Assist as necessary in the review of medical records.

• In collaboration with the HEDIS manager to develop annual HEDIS project plans and monitor the HEDIS project plans for multiple LOBs.

• Assist in preparation for the HEDIS audit.

• Develop and maintain HEDIS based report to support Quality Initiatives.

• Represent HEDIS team in collaboration with internal departments for HEDIS improvement.

• Ensures all data sent to HEDIS software vendor are accurate and meet HEDIS reporting timeline.

• Assists as necessary in the HEDIS Road Map and all other documents required by auditors.

• Able to assimilate into team within minimum amount of assistance

• Assures the ongoing high-performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers

• Experience and ability to utilize a certified HEDIS software

• Experience reviewing medical records is a plus

• Bachelor’s Degree required with a concentration in health care related field;

• Minimum 2 years HEDIS experience required.

• Requires 4-6 years of experience in healthcare and/or managed care

• Healthcare payer experience preferred

• SQL experience required. Tableau / Power BI experience preferred

• Experience utilizing a certified HEDIS software

Work-at-home requirements

• Must have the ability to provide a non-cellular High Speed Internet Service such as Fiber, DSL, or cable Modems for a home office.

• A minimum standard speed for optimal performance of 30x5 (30mpbs download x 5mpbs upload) is required.

• Latency (ping) response time lower than 80 ms

• Hotspots, satellite and wireless internet service is NOT allowed for this role.

• A dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information

How we value you

• Competitive pay/salary ranges

• Incentive plan

• Health/Vision/Dental benefits effective day one

• 401(k) retirement plan: company match – dollar for dollar up to 4% employee contribution (pretax or Roth options) plus a 6% annual company contribution

• Robust employee well-being program

• Paid Time Off

• Personal Community Enrichment Time

• Company-provided Basic Life and AD&D

• Company-provided Short-Term & Long-Term Disability

• Tuition Assistance Program

Please note that the salary information is a general guideline only. GEHA considers factors such as (but not limited to) scope and responsibilities of the position, candidate’s work experience, education/training, key skills, internal peer equity, as well as, market and business considerations when extending an offer.

The annual base salary range for this position is $69,639 - $97,561 USD.

GEHA is an Equal Opportunity Employer, which means we will not discriminate against any individual based on sex, race, color, national origin, disability, religion, age, military status, genetic information, veteran status, pregnancy, marital status, gender identity, and sexual orientation, as well as all other characteristics and qualities protected by federal, state, or local law. GEHA will not discriminate against employees or applicants because they have inquired about, discussed, or disclosed their compensation or the compensation of another employee or applicant. We are committed to creating an inclusive environment for all employees. Our diversity drives innovation deepens connections and strengthens our organization.

GEHA is headquartered in Lee's Summit, Missouri, in the Kansas City area. We recognize the importance of balance and flexibility and offer hybrid and work-from-home options for many of our roles.

An Executive Order was released stating that federal contractors must require COVID-19 vaccinations for all US employees. As a company that works on federal contracts, we have a legal requirement to comply with the executive order, if it is enforced.

GEHA (Government Employees Health Association, Inc., pronounced G.E.H.A.) is a nonprofit member association that provides medical and dental benefits to more than two million federal employees and retirees, military retirees and their families. Offering one of the largest medical and dental benefit provider networks available to federal employees in the United States, GEHA empowers health and wellness by meeting its members where they are, when they need care. A mong our core values is embracing diversity and inclusion, where we thrive by creating an environment in which each of our employees feels a sense of belonging, can engage their full potential and focus on enriching our people, culture and community.

Your FUTURE is here with us – COME GROW WITH GEHA!

Benefits start on day one! Great 401(k) match! Tuition assistance programs! Professional development! Advancement opportunities!

For additional information, please visit GEHA Careers. (https://www.geha.com/careers)