HEDIS Coordinator

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