Client Description: Our client is a leading healthcare company that provides services to government sponsored healthcare individuals.
Position Summary: The HEDIS Coordinator is responsible for assisting with quality improvement initiatives in the service and clinical areas, and will also ensure data accuracy and reporting.
Principle Duties and Responsibilities:
- Update clinical quality metrics
- Coordinate HEDIS processes and establish a plan to improve 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
- 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