[Remote] Healthcare Effectiveness Data and Information Set (HEDIS) Consultant

Note: The job is a remote job and is open to candidates in USA. Umbrex is an insurance company seeking a Healthcare Effectiveness Data and Information Set (HEDIS) consultant to lead their HEDIS submission process. The role involves leading the full HEDIS audit cycle, ensuring data accuracy, and managing submissions to CMS while providing expert guidance and establishing best practices. Responsibilities • Lead the end-to-end HEDIS audit cycle, including data validation, exclusions, and reporting. • Prepare, review, and submit HEDIS measures to NCQA-certified auditors and CMS. • Collaborate with internal teams to ensure compliance with HEDIS specifications and CMS reporting requirements. • Identify gaps or errors in data collection and recommend corrective actions. • Provide subject matter expertise and training to internal staff on HEDIS processes and best practices. • Act as primary liaison with auditors during the review and submission process. • Ensure timely completion of all HEDIS submissions and audit requirements. Skills • Deep subject matter expertise in HEDIS measures and audit cycles. • Proven experience leading multiple full HEDIS audit cycles. • Strong understanding of HEDIS data specifications, numerator/denominator rules, and exclusions. • Experience coordinating with NCQA-certified auditors. • Excellent analytical, organizational, and communication skills. Benefits • This is a 1099 contract role that does not offer health benefits Company Overview • Umbrex is a global community of independent, top-tier management consultants. It was founded in 2013, and is headquartered in Astoria, New York, USA, with a workforce of 11-50 employees. Its website is Apply tot his job