The Important Role of HEDIS Workers In Healthcare

The Important Role of HEDIS Workers In Healthcare

A growing career field in the healthcare industry involves HEDIS, a specialized system of performance measurements for managed care companies.

Designed to help consumers compare insurance plans and for managed care companies to attain accreditation, HEDIS has become more important than ever.

It’s an area where Samstaff specializes in matching the right personnel with the right employer.

HEDIS jobs include nurses, coordinators, auditors and coders, among others. These are vital parts of managed care organizations. HEDIS measurements provide an “apples to apples” comparison between health plans because of structure and consistency.

Why HEDIS

HEDIS – which stands for healthcare effectiveness data and information set – was created by the National Committee for Quality Assurance (NCQA). It measures the performance of health plans across many different metrics.

According to NCQA, more than 90 percent of health plans use HEDIS to measure quality and performance.

Data for a HEDIS report is collected in five primary areas: effectiveness of care, availability of care, experience of care, utilization and health plan descriptive information.

The more than 80 metrics used for patients in a health plan through HEDIS include health-related issues such as asthma medication use, body mass index assessments, controlling high blood pressure, breast cancer screenings and diabetes care.

All this information is certified by auditors using a structured assessment plan designed by NCQA.

Using HEDIS

Health plans use this information as one component in earning accreditation from NCQA, but there are many other uses. For example, they include:

  • Health plans using the information to improve health plan delivery and services
  • Employers and consumers use the data to choose between health plans
  • Information from HEDIS reports help create the annual State of Health Care Quality report from NCQA
  • Media outlets use data from the quality report to create information about the state of healthcare in the U.S.

For health plan companies, HEDIS is one of the areas of primary focus in the operation because accurately reporting numbers and ensuring that the operation meets set standards are top priorities in the industry.

The Need For Quality HEDIS Workers

Health payers need skilled workers in HEDIS because managing its implementation is a complicated process. The workers involved include nurses, coders, coordinators and data validators.

Data collected from a variety of sources creates a HEDIS report. These include patient surveys, medical charts and insurance claims with data on hospital visits, doctor’s office visits and medical procedures conducted.

The need for skilled workers in this area continues to grow as the healthcare system itself grows. The more patients in the system, the more data that is collected and analyzed.

For medical professionals who want to get into HEDIS work, the attraction is having the opportunity to step away from day-to-day care and look at issues that can improve the overall medical care system. Quality improvement and better patient outcomes are always the main goal of healthcare. Those who work in HEDIS play a critical role to ensure these standards are met.

For those seeking a job in HEDIS, a good place to start is Samstaff, where professional recruiters have expertise in finding the best openings available in the career field. With a focus on connecting people with job openings that allow them to feel purpose and where they can make a difference, Samstaff candidate advocates are “obsessive about the candidate experience.”

That’s a good partner to have when searching for positions involved with HEDIS and many other healthcare industry specialties.

By | 2018-02-21T10:13:02+00:00 January 31st, 2018|