HEDIS Coordinator

Title HEDIS Coordinator
Job Type Fulltime
Salary $60K-83K, DOE
Location Sacramento, CA
Details

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

Essential/Desired Qualifications:

  • 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
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