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Mgr. HEDIS, Insurance Serv.

Requisition ID
2025-46728
Category
Professional
Shift Type
Full-Time
Shift
8 Hour
Shift Schedule
Days
Facility
Community Medical Centers - Corporate Offices (CMC)
Location
US-CA-Fresno
Posted Date
7/15/2025
Min
USD $61.37/Hr.
Max
USD $79.78/Hr.

Overview

We got our start 125 years ago as a boarding house and medical facility for people traveling in Central California. If people then could see us now... Today, Community Health System is the region’s largest healthcare provider and includes three divisions: Community Medical Centers hospitals, Community Care Health and Community Provider Network. These three pillars of healthcare – hospitals, health insurance and physicians – work best when they work together.

 

Commitment to diversity and inclusion is a cornerstone of our culture at Community. All are welcome as valued members of our community.

We know that our ability to provide the highest level of care begins with taking care of our incredible teams. Want to learn more? Click here. 

Responsibilities

The Healthcare Effectiveness Data and Information Set (HEDIS) Manager leads the annual HEDIS reporting process and performance improvement efforts. This includes overseeing data operations, coordinating with vendors and internal departments, managing audits and submissions, and developing systems and strategies to support accurate and efficient reporting. The Manager combines technical data expertise with project management and communication skills to support National Committee for Quality Assurance (NCQA) accreditation and drive quality performance initiatives across Community Care Health (CCH).
 
 

Qualifications

Education
  • Bachelor's Degree in Healthcare Administration, Public Health, Nursing, or related field required
  • Master's Degree preferred

Experience

  • 5 years of experience in HEDIS or quality improvement within a health plan or healthcare environment required
  • Experience working with California regulatory agencies (e.g., DMHC) required
  • Familiarity with CAHPS and HEQMS reporting required
 Licenses and Certifications
  • CPHQ - Certified Professional Healthcare Quality required

 

 

Disclaimers

• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.

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