Healthcare Effectiveness Data and Information Set (HEDIS) Consultant

Healthcare Effectiveness Data and Information Set (HEDIS) ConsultantOur client is an insurance company seeking a Healthcare Effectiveness Data and Information Set (HEDIS) consultant to lead their HEDIS submission process. The organization is looking to strengthen its capabilities in accurately preparing, validating, and submitting HEDIS data to auditors and CMS. The HEDIS Consultant will be responsible for leading the full HEDIS audit cycle, ensuring data accuracy, and managing submissions to CMS.This role requires a hands‑on leader who can provide expert guidance, coordinate with auditors, and establish best practices for data management and reporting. Key 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. Qualifications:• 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. Start: December or JanuaryDuration: 5 monthsTime commitment: Part or full timeLocation: RemoteProject ID#: 8088Contract type: 1099 (no health benefits)Seniority levelMid‑Senior levelEmployment typeContractJob functionInsurance Apply tot his job