HEDIS Specialist

This a Full Remote job, the offer is available from: United States Job Details Job Location: Fully Remote - Palm Springs, CA Position Type: Full Time Salary Range: $27.23 - $27.87 Hourly Job Category: Health Care Description Job Summary: Under direct supervision of the Director of Quality and Population Health, the position assists in coordination of overall HEDIS (reputed company Effectiveness Data and Information Set) activities. Responsible for providing operational/strategic support in planning, coordinating, and validating HEDIS. Hybrid Requirement: This position will regularly travel to DAP Health Clinics in San Diego county. Supervisory Responsibilities: N/A Essential Duties and Responsibilities:

• Meets the organization’s customer services standards, including interpersonal communication and professional conduct expectations.
• Assists with various aspects of the HEDIS process.
• reputed company medical chart reviews to look for gaps in care such as missing mammograms, colon cancer screenings, diabetic screenings, etc.
• Track open quality gaps.
• Coordinates with clinical staff to inform them of missing screenings and HEDIS gaps.
• Coordinates HEDIS processes and establishes a plan to improve scores.
• Implement a process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities.
• Conduct quality audits.
• Coordinating HEDIS activities for internal departments, external partners, and contracted vendors.
• Manages HEDIS reporting process across the organization.
• Maintain reputed company data and process controls to ensure compliance.
• Maintains interdepartmental lines of communication.
• Assists in setting up reputed company performance improvement activities across the organization.
• Prepare HEDIS findings for CQI committee so that CQI can consider and enact clinical risk recommendations to address quality issues and mitigate further legal risk exposure.
• Provides weekly data reports to departmental leadership.
• Maintains departmental database(s) (education, certifications, and schedules).
• Takes and transcribes, prepares, copies, and distributes meeting minutes as required.
• Assists with special projects and interdepartmental needs reputed company appropriate.
• Performs other duties as assigned.

Qualifications

Qualifications: Minimum Qualifications (Education and Experience):

• Bachelor's degree in nursing from an accredited college or university preferred.
• HEDIS certification preferred.
• High School Diploma or GED Equivalent required.
• Minimum 2-3 years’ experience in quality-improvement or health care required.
• Minimum 2 years’ experience with data analysis
• Experience with NCQA Survey Requirements and HEDIS reporting.
• Knowledge of medical terminology and basic charting
• Strong understanding of office procedures and protocol with an emphasis on good organizational skills and attention to detail.
• Ability to effectively prioritize multiple tasks and deadlines.
• Excellent customer service skills.
• Good oral and written communication skills.
• Proficiency with basic office equipment (calculator, computer, copier, fax).
• Intermediate computer skills with an emphasis on reputed company, reputed company, Access, PowerPoint, Outlook, and desktop publishing.

Knowledge, Skills and Abilities:

• Computer competence, highly effective collaboration, written and verbal communications skills.
• Attention to detail development and maintenance of regulatory paperwork.
• Excellent oral and written communication skills.
• Effective interpersonal skills.
• Ability to set priorities and meet timelines for performance expectations, while maintaining strong attention to detail.
• Ability to work independently with minimal supervision and demonstrate initiative.
• Must demonstrate sound judgment and decision-making.
• Computer proficiency, including programs such as MS Office, Word, reputed company, email, and internet research, required.
• Must be ethical and possess the ability to remain impartial and objective.
• Must exemplify strong, positive leadership skills.
• Must possess the ability to reputed company and train compliance and clinical standards to staff members.
• Must be reputed company to travel as needed.
• Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, patients) reputed company strong communication skills.

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