Job Id: 60435
This position assists the Healthcare Effectiveness Data and Information Set (HEDIS) team with coordination of data gathering, auditing and analysis projects for Medicare and Medicaid lines of business. Specific projects include but are not limited to HEDIS for Medicare, CCO incentive metrics involving chart review and focused projects intended to improve HEDIS, CMS Star scores and OHA Incentive Metrics scores. This position works collaborative to coordinate work both within and outside of the Medicare Department.
This position is remote and must live in one of these States: OR, WA, ID, UT, NV, AZ.
HEDIS Coordinator Responsibilities:
Coordinate Clinical Review team EMR access to clinic systems and partner with clinic systems to develop EMR access improvement plans. Develop and maintain a good working relationship with clinics, clinic system ROI departments and encourage more remote access when requesting medical records. Maintain a listing of remote EMR systems that each HEDIS team has access to and submit requests for access as needed.
Coordinate all functions for medical record fax requests using certified HEDIS software or other specialized software.
Coordinate data collection, including locating, obtaining, and preparing for medical records review or remote EMR access.
Assist the RN Quality Assurance team with medical record review for various projects while maintaining >95% accuracy and medical record review for various Medicare and Medicaid projects.
Collaborate with the HEDIS Supervisor and RN Quality Assurance Lead on special assignments and projects, as needed.
Assist in the development and coordination of project assignments and plans that outline tasks, communications, milestones, priorities, needs and resources, as needed.
Work with functional area managers, healthcare providers, company members and vendors to assure optimal project outcomes.
Assist in identifying project members and related partners and community stakeholders.
Coordinate and work with all involved parties to review and modify project plan as necessary to deliver project outcomes.
Identify potential difficulties and/or barriers to project goals and mitigate or avoid them.
Organize, facilitate, and participate in meetings of stakeholder groups to identify needs and build consensus and collaboration.
Track and communication work status to ensure progress toward completion and within agreed upon timelines, budget, etc.
Discuss with HEDIS Supervisor modifications of project plans when needed in response to unforeseen changes or unexpected developments, and inform management, partners, and stakeholders.
Consult with staff, partners, and stakeholders to resolve issues, identify/minimize risks, and develop contingency plans.
Analyze, collect, prepare, and distribute appropriate materials for meetings, as assigned.
Locate, assemble, edit and summarize materials, information and data as requested.
Maintain appropriate records, information, documentation and reports.
Provide updates on work status/progress in team meetings as needed.
Work collaboratively to coordinate work both within and outside the Medicare department.
Assist with tracking project goals and monitor progress, project milestones, engage stakeholders, ensure quality of outcomes and ensure delivery of results.
Act as a liaison between internal and external partners and stakeholders to facilitate collaboration and maintain project reports, records and documentation.
Perform work in alignment with the organization’s mission, vision and values.
Support the organization’s commitment to equity, diversity and inclusion by fostering a culture of open mindedness, cultural awareness, compassion and respect for all individuals.
Strive to meet annual business goals in support of the organization’s strategic goals.
Adhere to the organization’s policies, procedures and other relevant compliance needs.
Perform other duties as needed.
HEDIS Coordinator Qualifications:
Minimum 3 years’ experience working in healthcare.
Minimum 2 years’ experience in HEDIS/OHA/Quality metrics.
Minimum 2 years’ experience with project coordination.
Experience working with health plans and Medicare.
Knowledge, Skills and Abilities Required:
Basic knowledge of principles, methods, and techniques of project management and effective organizational change management.
Knowledge and understanding of HEDIS, CMS Star ratings, and OHA specifications and measures.
Knowledge of HIPAA guidelines and compliant transactions.
Skills and Abilities
Meeting facilitation skills.
Strong computer skills, including proficiency with Microsoft Project, Word, Excel, PowerPoint, Outlook, and Visio.
Effective oral and written communication and presentation skills including ability to articulate concepts to staff, partners and stakeholders.
Well-developed organizational, analytical and problem-solving skills.
Significant self-direction/self-management skills with the ability to work independently and effectively as a sole contributor and as part of a team.
Ability to learn healthcare performance analytics software.
Ability to develop project plans, prioritize tasks and meet objectives.
Ability to informally lead peers, cross-functional partners and management toward project goal attainment.
Ability to develop a project plan to manage and implement project tasks and activities to achieve goals within established timeline and budget.
Ability to identify and anticipate issues and act proactively to formulate plans and recommendations to address potential issues.
Ability to manage multiple projects, activities, organization communications, and frequently competing priorities to implement change as necessary within budget constraints.
Ability to critically evaluate information gathered from multiple sources.
Ability to proactively communicate and collaborate with external and internal customers to analyze information needed.
Ability to use motivation, persuasion and encouragement in order to complete projects.
Ability to work effectively with diverse individuals and groups.
Ability to learn, focus, understand, and evaluate information and determine appropriate actions.
Ability to accept direction and feedback, as well as tolerate and manage stress.
Ability to see, read, and perform repetitive finger and wrist movement for at least 6 hours/day.
Ability to hear and speak clearly for at least 3-6 hours/day.
Salary: $48,544k-$72,816k/yr. (DOE)
Our client is thrilled to offer benefit eligible employees a competitive and robust total rewards package that includes comprehensive benefit offerings. These benefits are designed to provide employees and their families with a range of options to meet and support their personalized needs.
VanderHouwen is an award-winning, Women-Owned, WBENC certified professional staffing firm. Founded in 1987, VanderHouwen has been successfully placing experienced professionals throughout the Pacific Northwest and nationwide. Our recruitment teams are highly specialized in either Technology and IT, Engineering, or Accounting and Finance career markets. Our recruiters value building meaningful, professional relationships with each candidate as well as developing honed knowledge of companies' staffing needs and workplaces. Partner with us to land your next exciting career.
VanderHouwen is an Equal Opportunity Employer and participates in E-Verify. VanderHouwen does not discriminate on the basis of race, color, religion, sex, national origin, age, disability, or any other characteristic protected by applicable local, state or federal civil rights laws.
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