HEDIS Coordinator (Remote Option-NC)
About the positionResponsibilities• Compliance Oversight: Ensuring adherence to HEDIS standards by overseeing data collection, analysis, and reporting processes. • Data Management: Managing the collection, validation, and aggregation of data required for HEDIS reporting. • Quality Improvement Support: Collaborating with Quality Improvement teams and Quality Practice Advisors to identify opportunities for improvement based on HEDIS data analysis. • Documentation and Coding Support: Providing guidance to healthcare providers on proper documentation practices to accurately reflect patient care.• Performance Monitoring: Monitoring performance metrics related to HEDIS measures and identifying areas of concern or improvement. • Training andEducation: Conducting training sessions or workshops to educate staff and providers on HEDIS measures. • Interdepartmental Coordination: Acting as a liaison between different departments involved in HEDIS reporting and quality improvement efforts. • Audit Preparation: Assisting in the preparation for HEDIS audits by ensuring all necessary documentation and data are accurate.• Member Outreach: Engaging with members to educate them about HEDIS measures and promote participation in healthcare programs. • Continuous Improvement: Continuously evaluating processes and procedures related to HEDIS reporting and quality improvement. Requirements• High School Diploma or equivalent. • Minimum 3-5 years of experience in healthcare administration, medical records, or healthcare data management. • Minimum 2 years of experience with healthcare quality measures or clinical data reporting.• Experience with HEDIS measures, healthcare auditing, or quality improvement initiatives. • Demonstrated experience working with healthcare providers and clinical documentation. • Experience coordinating projects and managing multiple deadlines in healthcare setting. • Knowledge of HEDIS coding requirements. • Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, data analysis functions). • Experience with healthcare databases and electronic health record systems. • Demonstrated ability to collect, validate, and analyze healthcare data.Nice-to-haves• Associate or bachelor's degree in healthcare administration, Health Information Management, or related field. • 7+ years of experience in managed care or health plan environment. • Previous experience in HEDIS reporting and NCQA accreditation processes. • Experience with SQL, SAS, R, or other data analysis software. • Experience in Medicare Advantage and Medicaid managed care operations. • Project ManagementProfessional (PMP) certification. • Six Sigma Green Belt or similar quality improvement certification.Benefits• Annual incentive bonus plan. • Medical, dental, and vision insurance with low deductible/low cost health plan. • Generous vacation and sick time accrual. • 12 paid holidays. • State Retirement (pension plan). • 401(k) Plan with employer match. • Company paid life and disability insurance. • Wellness Programs. • Public Service Loan Forgiveness Qualifying Employer. Apply tot his job