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Job description
Position Title: HEDIS Coordinator
Work Location: Remote, no specific state or time zone
Assignment Duration: 2 months potential to extend
Work Schedule: 8 hour work day, no OT M-F 8-5 in their time zone
Work Arrangement: Remote
Position Summary:
Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the service and clinical areas.
Background & Context:
We are needing assistance in Q4 to bring in more records to close HEDIS care gaps and review submitted records. We have a strong team that is very knowledgeable in HEDIS, but are needing extra assistance to pull and process records for Medicaid and Marketplace populations.
Key Responsibilities:
Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results
Establish and maintain an action plan to improve HEDIS scores
Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidences, documentations, and changes
Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality
Conduct quality audit and maintain all data and process controls to ensure compliance
Performs other duties as assigned
Complies with all policies and standards
Qualification & Experience:
Candidate Requirements Education/Certification Required: 3+ years in Quality Improvement/HEDIS Preferred: Bachelor's Degree Licensure Required: NA Preferred: Years of experience required: Bachelor's degree in related field or equivalent experience. 3+ years of quality improvement or healthcare related experience. Working knowledge of the National Committee on Quality Assurance (NCQA). HEDIS requirements preferred.
Disqualifiers: No knowledge or work history with HEDIS
Additional qualities to look for: Strong HEDIS measure experience, EMR experience Top 3 must-have hard skills stack-ranked by importance
1 HEDIS and EMR experience 2 Microsoft Application experience, Excel 3 Team collaborator and driven focus on task
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.