HEDIS Project Specialist, Temporary

Regal Medical Group • Orange, CA

18h

About The Position

The HEDIS Project Specialist will serve as the health navigator and may include member outreach by scheduling appointments for targeted HEDIS measures and/or provider outreach for data reconciliation.

Requirements

• Experience in patient outreach/advocacy.
• Excellent organizational, communication, and problem-solving skills.
• Ability to work independently and manage multiple tasks efficiently.
• Proficiency in electronic medical records (EMR) and data tracking systems.
• Intermediate or advanced MS Office proficiency

Nice To Haves

• Strong knowledge of Medicare and HEDIS preferred but not required.

Responsibilities

• Patient Outreach & Scheduling: Utilize the company proprietary tracker to outreach members with open care gaps to schedule necessary appointments.
• Medical record retrievals to obtain medical records via provider outreach, EMR systems, our internal systems and lab portals, review them carefully for accuracy to ensure that they have all the requirements indicated in the NCQA HEDIS manual and date entering any usable date into q.HMO.
• Work closely with the provider organization to ensure necessary documentation is properly submitted through supplemental data.
• Completing the BSC HN Tracker accurately and submitting it timely to the program manager monthly.
• Attend bi-weekly or monthly meetings and communicate barriers, progress and updates.
• Perform additional tasks as assigned by management.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: No Education Listed