As the largest and leading value-based kidney care company, Somatus is empowering patients across the country living with chronic kidney disease to experience more days out of the hospital and healthier at home.

It takes a village of passionate and tenacious innovators to revolutionize an industry and support individuals living with a chronic disease to fulfill our purpose of creating More Lives, Better Lived. Does this sound like you?

Showing Up Somatus Strong

We foster an inclusive work environment that promotes collaboration and innovation at every level. Our values bring our mission to life and serve as the DNA for every decision we make:

• Authenticity: We believe in real dialogue. In any interaction, with patients, partners, vendors, or our teammates, we are true to who we are, say what we mean, and mean what we say.
• Collaboration: We appreciate what every person at Somatus brings to the table and believe that together we can do and achieve more.
• Empowerment: We make sure every voice gets heard and all ideas are considered, especially when it comes to our patients’ lives or our partners’ best interests.
• Innovation: We relentlessly look for ways to improve upon the status quo to continuously deliver new solutions.
• Tenacity: We see challenges as opportunities for growth and improvement — especially when new solutions will make a difference for our patients and partners.

Showing Up for You

We offer more than 25 Health, Growth, and Wealth Work Perks to help teammates learn, grow, and be the best version of themselves, including:

• Subsidized, personal healthcare coverage (medical, dental vision)
• Flexible Paid Time Off (PTO)
• Professional Development, CEU, and Tuition Reimbursement
• Curated Wellness Benefits supporting teammates physical and mental well-being
• Community engagement opportunities
• And more!

The HEDIS Supervisor will be responsible for providing operational support in planning, coordinating, and validating HEDIS, medical record reviews. This role will oversee the staff that directly impact gap closure through member and provider engagement.

Essential Duties and Responsibilities:

• Serve as a subject matter expert to operational and leadership teams.
• Ensure compliance by conducting quality audits and maintaining all data and process controls for the HEDIS coordinator team
• Oversee the HEDIS project for quality and timeliness regarding nurse assignments, vendor oversight, and timeline adherence
• Organize and maintain a plan of action to improve HEDIS scores
• Support the Manager to request and evaluate reports for member compliance and improvement opportunities for each HEDIS measure
• Manage data gathering processes for performance tracking and reporting.
• Monitor and analyze the effectiveness of various care gap initiatives, infrastructure, and reporting, and make recommendations to improve outcomes.
• Work with the HEDIS leadership to report data trends related to gaps in care performance and develop action plans as needed.
• Evaluate internal and vendor workflows to ensure optimal processes are effective to address gaps in care.
• Support the HEDIS manager to conduct meetings with operations to review performance.
• Collaborate across cross functional teams on initiatives to address care gap.
• Collaborate with the coding department to monitor use off codes such as CPT II, ICD-10, HCPCS, etc., are identified and submitted to health plans and CMS for all members.
• Ensure daily/monthly call volume targets are being met.
• Ensure daily/monthly gap targets are being met.
• Train and evaluate HEDIS Coordinator performance.

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Required Education and Experience:

Required

• Associate’s degree or equivalent experience
• 1-2+ years of experience with HEDIS
• 1-2+ years of lead or supervisory experience
• Proficiency in compiling, analyzing, and interpreting data trends and working with large data sets.
• Superb communication skills (written and verbal) to effectively communicate across teams, levels and functions.
• Strong organizational and time management skills.
• Ability to give and receive feedback and constructive criticism.
• Candidates must also have very strong presentation skills using tools like PowerPoint, Excel, etc. along with the ability to create compelling and dynamic presentations.
• Possess intermediate level of knowledge of NCQA HEDIS regulations.
• Possess intermediate level of knowledge of National Quality Forum.

Preferred

• Batchelor’s degree in business administration or advanced degree.

Knowledge, Skills, and Abilities:

• Ability to document and analyze complex business requirements and processes
• Must be a proactive, hands-on leader with a proven strategic vision who will drive operational performance with a high degree of accountability and integrity
• Strong analytical skills
• Acute attention to detail
• Ability to be both a strategic and tactical change agent in the healthcare space
• Self-starter who will take initiative and be proactive when there are multiple priorities
• Strategic solution-seeker who sees opportunities when others see barriers
• Strong interpersonal skills and ability to communicate effectively
• Ability to handle ambiguity and desire to work in a fast-paced start-up environment