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Job Details

HEDIS Nurse Manager

Requisition #: 188426
Location: Johns Hopkins Health Care, Hanover, MD 21076
Category: Manager/Supervisor
Work Shift: Day Shift
Work Week: Full Time (40 hours)
Weekend Work Required: No
Date Posted: Sept. 13, 2019

Johns Hopkins Health System employs more than 20,000 people annually. Upon joining Johns Hopkins Health System, you become part of a diverse organization dedicated to its patients, their families, and the community we serve, as well as to our employees. Career opportunities are available in academic and community hospital settings, home care services, physician practices, international affiliate locations and in the health insurance industry. If you share in our vision, mission and values and also have exceptional customer service and technical skills, we invite you to join those who are leaders and innovators in the healthcare field.

This position is responsible for the coordination and development of activities and functions of quality improvement initiatives to include planning, design, establishing, and implementation. Provides direction and oversees management of area of responsibility as well as develops and implements policies and procedures and provides recommendation for changes when applicable. Works collaboratively with other teams/departments regarding delegation oversight which includes first tier, downstream, and related entities (FDR) as defined by the Centers for Medicare and Medicaid (CMS) as well as NCQA requirements.

The Manager, QI (HEDIS) manages and collaborates with internal and external customers (such as the hospital and hospital clinics) to ensure all HEDIS projects are on task and meeting timelines. Responsible for management and oversight of designing and coordinating HEDIS measurement, reporting functions, and improvement activities. Responsibilities include HEDIS regulatory compliance, optimization of data analysis and collection strategies, HEDIS workflow processes improvement, and managing priorities through the timeline. The Manager will work with the JHHC Compliance Director throughout the HEDIS season (including pre work and post audit activities) for oversight assurance. The Manager will work collaboratively with JHM partners including JHH, JHBMC Clinics and JHCP Quality Directors for initiative planning and quality improvement. In addition, the Manager will support the Value Based Purchasing goals and work closely with the Value Based Purchasing (VBP) Project Manager to support overall HEDIS/VBP measure success for our membership and the Company.


A. Education

Requires a Bachelor’s degree in Nursing or related health care administration field. Master’s degree in Nursing or Healthcare Administration preferred. RN with equivalent work experience may be substituted as appropriate.

B. Knowledge:

Requires professional level of knowledge NCQA ®, HEDIS ® and VBP measures, Quality Care Standards, accreditation, audit and review processes.

Knowledge of Microsoft Office and Access/Excel databases.

C. Skills:

Strong supervisory skills; must plan and direct the work of a diversified staff.

Strong analytical ability to solve complex problems. Must possess advanced interpersonal skills to effectively interface with all levels of staff as well as external business-related associates.

Requires leadership ability to effectively communicate (oral and written) and direct area staff.

Requires excellent analytical, organizational, oral and written communications skills, the ability to manage multiple tasks and priorities, the ability to independently resolve complex issues and keep management appropriately informed. Also requires good leadership and team building skills. Work requires reinforcing accountability for meeting deadlines and quality standards, identifying opportunities for process and procedural improvements, ability to handle sensitive and confidential information, and the ability to communicate and exchange information with all internal and external customers.

Must possess proficient PC skills and demonstrate proficient usage of various types of software to include spreadsheets, databases, etc. In addition, has the ability to use highly specialized/customized software for database management and preparation.

D. Required Licensure, Certification, Etc.:

Requires active licensure as a Registered Nurse in the State of Maryland. Health Care Quality or Safety Certification preferred.

E. Work Experience:

Requires at least five years of experience with specified subject matter. Must have experience with conducting and monitoring the medical record review process. Three Years Management or Supervisory experience required.


Johns Hopkins Health System and its affiliates are drug-free workplace employers.

Johns Hopkins Health System and its affiliates are an Equal Opportunity / Affirmative Action employers. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity and expression, age, national origin, mental or physical disability, genetic information, veteran status, or any other status protected by federal, state, or local law.


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