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: