HEDIS COORDINATOR (2225)

VIVANT HEALTH•Sacramento, CA

4d•Onsite

About The Position

The HEDIS Coordinator serves as a consultant, educator, and subject matter expert in the use of HEDIS data and the quality improvement process. The HEDIS Coordinator will be responsible for coordinating and completing specific projects ensuring consistency with company strategy, commitments, and goals.

Requirements

Two (2) + years’ experience working in medical environment using EMR systems (in general), and/or claims data, and/or medical review abstraction and chasing.
Three (3) + years’ experience working in a professional leadership role, using independent judgment and critical thinking skills.
Ability to learn, comprehend and teach HEDIS information.
Must have reliable transportation for local travel requirements.
Understanding of claims, providers, and membership systems, or similar database systems.
Excellent organizational, problem solving and follow-up skills with attention to detail.
Strong leadership skills and ability to enlist the support and actions of affiliated physicians and their office team by demonstrating professionalism, integrity, and being of service to others.
Proactively takes initiative and anticipates provider needs while prioritizing and managing issues.
Ability to champion changing priorities, implement process improvements, and effectively present information and respond to questions from providers.
Excellent communication skills, including both oral and written.
Excellent active listening and critical thinking skills.
Ability to solve mid-level problems with minimal supervision.
Ability to multi-task, exercise excellent time management, and meet multiple deadlines.
Self-motivated with strong organizational, multi-tasking, planning, and follow up skills
Demonstrated excellence in project management and organization.
Ability to provide and receive constructive job and/or industry related feedback.
Ability to maintain confidentiality and appropriately share information on a need to know basis.
Ability to exercise sound discretion and strict maintenance of confidentiality of all confidential and sensitive communications and information.
Ability to consistently deliver excellent customer service.
Excellent attention to detail and ability to document information accurately.
Ability to effectively and positively work in a dynamic, fast-paced team environment and achieve objectives.
Must have mid-level skills in Microsoft software (Word, Excel, PowerPoint).
Must have the ability to quickly learn and use new software tools.
Must have mid-level skills using e-mail applications.
Self-motivated with strong organizational, multi-tasking, planning, and follow up skills.
Ability to work independently as well as in a team environment.
Demonstrate commitment to the organization’s mission.
Ability to present self in a professional manner and represent the Company image.
Availability to occasionally work outside normal business hours.
High School Diploma or GED minimum requirement.
Medical Assistant (MA) Diploma/Certification is required.
Active and unrestricted Driver’s License is required.
Current Auto Insurance is required.

Nice To Haves

Recent and related experience working with HEDIS criteria preferred.

Responsibilities

Coordinates and administers Quality program with primary care physician offices under the direction of the HEDIS Manager.
Advises primary care physicians on practice improvement opportunities as per IPA clinical advisement as they apply to HEDIS and claims submission.
Encourages physicians to implement best practices in timely claims submission, correct coding and medical management practices as they apply to HEDIS measures.
Help physicians identify opportunities to optimize HEDIS encounter data.
Documents all work in appropriate systems and work with Management to overcome any barriers with assigned provider offices.
Audits claims submission to ensure HEDIS measures are being captured via encounter data.
Use company programs to run reports and present them to management in timely manner
Performs related duties consistent with the scope and intent of the position.
Regular attendance.
Travel as required.
Enforces Company policies and safety procedures.
Regularly updates job knowledge by participating in educational opportunities, reading professional publications, maintaining professional networks, and participating in professional organizations.
Maintain IPA, Health Plan compliance standards.