HEDIS Analyst/MIPS
About The Position
The MIPS Compliance and Provider Development Specialist will support physicians and specialists within an Independent Physician Association (IPA) in achieving and maintaining compliance with the Merit-based Incentive Payment System (MIPS) and other CMS quality programs. This role combines regulatory compliance expertise with provider development, onboarding, and ongoing performance/support management to ensure the IPA’s network of providers meets quality standards, maximizes reimbursements, and sustains long-term success. This is a full-time position offering a dynamic opportunity to contribute to both the operational and strategic growth of the IPA.
Requirements
- Bachelor's degree in healthcare administration, Public Health, Health Information Management, or related field (master's preferred).
- Minimum of 3 years of experience with MIPS, MACRA, or other CMS quality reporting programs.
- Previous experience supporting an Independent Physician Association (IPA) or multi-specialty provider network is strongly preferred.
- Strong understanding of EHR systems, clinical quality measures, and healthcare compliance standards.
- Excellent communication, analytical, and organizational skills.
- Ability to manage multiple providers, projects, and deadlines in a fast-paced environment.
Responsibilities
- MIPS Compliance and Quality Reporting Guide IPA member providers and practice staff through MIPS program requirements, updates, and performance categories.
- Conduct workflow assessments to identify compliance gaps and implement corrective actions.
- Provide support and guidance to office managers regarding MIPS data collection, validation, and submission processes for all participating providers.
- Track and analyze provider performance metrics, generating detailed reports for IPA leadership.
- Deliver training sessions, webinars, and educational materials on MIPS, MACRA, and CMS quality initiatives.
- Collaborate with office managers to help them with EHR, billing teams, and administrative staff to optimize reporting accuracy and efficiency.
- Maintain awareness of CMS policy changes and communicate relevant updates to IPA members.
- Provider Development and Maintenance Support the onboarding of new IPA providers, ensuring they understand compliance expectations, reporting timelines, and quality benchmarks.
- Maintain provider profiles, credentialing documentation, and performance records to ensure continuous compliance of readiness.
- Develop individualized provider improvement plans to enhance MIPS scores and patient care outcomes.
- Serve as a liaison between providers and IPA leadership to align compliance and quality goals with organizational growth strategies.
- Monitor provider performance trends, identify opportunities for improvement, and implement ongoing support initiatives.
- Contribute to provider retention and satisfaction through education, communication, and performance support programs.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
