HEDIS Outreach Coordinator

Maryland Care Management Inc•Linthicum, MD

8d•Hybrid

About The Position

This position will be responsible for facilitating provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes. Provides support for “Healthcare Effectiveness Data and Information Set” (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are non-compliant in the designated outreach services. Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data. Maryland Care Management, Inc. (MCMI) manages Maryland Physician Care's (MPC) statewide provider network of hospitals and physicians. Maryland Physicians Care has been providing services to the HealthChoice Medicaid populations since 1996, and we are proud of our footprint in the community. With over 230,000 members, MPC consistently has been one of MD's largest Medicaid-managed care organizations.

Requirements

Proficiency in use of Microsoft Office Suite application software.
Effective problem-solving skills to procure data and information.
High school diploma or equivalent.
Minimum of 3 years’ recent and related health care marketing, outreach, and/or health education experience.
Recent and related experience working with HEDIS criteria; working in a call center environment.
Travel 15-20% throughout the state of Maryland.
Current driver’s license and reliable transportation.
May require working outside of normal business hours to include evenings and Saturdays.

Responsibilities

Integral part of the HEDIS team delivering member and provider education related to HEDIS care gaps.
Works with provider sites to assist with member scheduling of appointments and education r/t coding guidelines for HEDIS.
Responsible for scheduling and tracking of HEDIS-specific specialty clinics.
Responsible for inbound/outbound call queue to assist members with appointment scheduling, HEDIS initiatives, education.
Collaborate with the HEDIS team to deliver outreach initiatives to close care gaps.
Distributes educational information to members and providers in accordance with the HEDIS outreach work plan (mailings, social media, automated calls, etc.).
Conducts HEDIS provider chart request calls and mailings.
Maintains an incentive database to track member compliance.
May identify opportunities to partner with community organizations for special events and presentations (i.e., health fairs and community events).
Works with internal staff to schedule, organize, and staff these events.
Records and documents all member and provider outreach activity.
Engages in HEDIS relevant provider relationships, record retrieval during MRR project, requiring travel to offices throughout Maryland 10-25%.