POSITION SUMMARY/RESPONSIBILITIES
Leads the annual clinical quality monitoring and reporting activities for Healthcare Effectiveness Data and Information Set (HEDIS) and provides leadership for reporting of HEDIS rates. Supports quality and preventive health and disease management program activities in coordination with health plan staff as it relates to program metrics. Researches, organizes, and analyzes clinical data, outcomes, and metrics to ensure the highest quality of service, consistent with regulatory and accreditation guidelines.

EDUCATION/EXPERIENCE
Bachelor’s degree in Nursing or a health-related field is required. Master’s degree in a health-related field is preferred. Thorough knowledge of health care regulations, accreditation standards, HEDIS, quality management, and process improvement is required. Data analysis or statistical analysis experience is preferred.

LICENSURE/CERTIFICATION
Must be licensed as a Registered Nurse in the State of Texas.