OhioRISE HEDIS Analyst

Job DescriptionBusiness OverviewAs part of the bold vision to deliver the "Next Generation" of managed care in Ohio Medicaid, Ohio RISE will help struggling children and their families by focusing on the individual with strong coordination and partnership among MCOs, vendors, and ODM to support specialization in addressing critical needs. The OhioRISE Program is designed to provide comprehensive and highly coordinated behavioral health services for children with serious/complex behavioral health needs involved in, or at risk for involvement in, multiple child-serving systems.The HEDIS Analyst creates and executes specific deliverables and activities as part of a team assigned to a business-sponsored project. This position is a key contributor to overall project success. Performs analysis and translates business needs to create high-quality Business Requirements and Functional Specifications documentation within specified time frames to solve moderately complex problems (multiple interfaces with other systems within a business unit) considering all impacted components from an end-to-end perspective. Ensures end-to-end traceability of requirements is complete. Applies specific functional and/or business expertise to perform assigned tasks and develop specific project deliverables. Conducts impact analysis of technology changes on business processes and existing technology. Competent to work with minimal supervision in a technical capacity on most phases of the business systems analysis. Contributes to the review of Test Planning and Test Execution strategies. Develops business workflow diagrams. Assists in the development of data models and interface design specifications. Documents, tracks, and resolves issues related to data quality. Contributes to the design and mapping of data conversion strategies. Participates in collaborative system and data design sessions with the user community, technical architecture resources, and development resources. Completes project activities on time and within budget, and proactively identifies and communicates issues that may jeopardize milestones or project budget to the Project Manager. Adheres to APLC or AGILE project management methodology by utilizing internal procedures and tools and identifying areas for methodology improvement. Develops Product Overviews, FAQs, Tool Glossaries, system training material, and system user documentation to support implementation activities. Creates appropriate communication materials are documented and distributed appropriately. Guides and advises less-experienced Business Analysts. Conducts interviews, fact-finding, and independent research to design creative, progressive IT solutions for business problems.Required Qualifications 3+ years' Business Analyst experience. Must possess sound knowledge of structured data warehouse environment as well as the ability to work with large data sets from multiple data sources. Ability to import, manipulate, and extract data using Microsoft SQL language and database skills. Ability to manage and develop complex data for action planning and evaluation in Excel. Ability to successfully interact with members, medical professionals and health plan and government representatives.COVID RequirementsCOVID-19 Vaccination RequirementCVS Health requires certain colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, religious belief, or other legally recognized reasons that prevents them from being vaccinated. You are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status or apply for a reasonable accommodation within the first 10 days of your employment. Please note that in some states and roles, you may be required to provide proof of full vaccination or an approved reasonable accommodation before you can begin to actively work.Preferred Qualifications Medicaid and Managed care experience strongly preferred. Experience working with HEDIS analytics and data. Behavioral health background/experience is preferred. Bachelor's degree (BA/BS).EducationBachelor's degree in a Business or IT field, or an equivalent combination of education and work experience.Business OverviewBring your heart to CVS HealthEvery one of us at CVS Health shares a single, clear purpose: Bringing our heart to every moment of your health. This purpose guides our commitment to deliver enhanced human-centric health care for a rapidly changing world. Anchored in our brand - with heart at its center - our purpose sends a personal message that how we deliver our services is just as important as what we deliver.Our Heart At Work Behaviors support this purpose. We want everyone who works at CVS Health to feel empowered by the role they play in transforming our culture and accelerating our ability to innovate and deliver solutions to make health care more personal, convenient and affordable. We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an affirmative action employer, and is an equal opportunity employer, as are the physician-owned businesses for which CVS Health provides management services. We do not discriminate in recruiting, hiring, promotion, or any other personnel action based on race, ethnicity, color, national origin, sex/gender, sexual orientation, gender identity or expression, religion, age, disability, protected veteran status, or any other characteristic protected by applicable federal, state, or local law.

Created: 2024-10-19