Job Alert: HEDIS Coordinator

You do not need to be an RN for this opportunity in QUALITY!  This role is responsible for ensuring HEDIS data accuracy and reporting, including coordinating and updating management on clinical quality metrics and HEDIS processes and results.  This will also include investigation, auditing, and process improvement opportunities. You will assist with quality improvement initiatives in the service and clinical areas.

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Position Purpose:
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.

Knowledge/Experience:
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.

Skills/Competencies:
Knowledge Worker:  Critical Thinking/Execution, Adaptability/Flexibility, Communication/Relationship Development, Technical and Professional Knowledge

Position 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