HEDIS Outreach Coordinator

Position Summary

Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services.
Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.
Performs provider/location research, clean up, and data updates to ensure that medical record requests are submitted to the right location and PHI is properly handled
Conducts HEDIS provider chart request calls, faxes, and mailings.
Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measure rates
Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes and close gaps in care.
Identifies when to refer member to Social Worker or Case Manager.
Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.
Documents member participation in outreach activities in accordance with abstraction and audit standards.
Records and documents all member and provider outreach activity.
Performs other duties as required.

Required Qualifications

Minimum 1 year’s, recent HEDIS project support-related experience
Strong communication skills and experience speaking with medical providers.
Ability to work independently.
Ability to use standard corporate software packages and corporate applications.
Computer skills: Microsoft Word, Excel, Outlook, Teams, Adobe Reader, RightFax

Preferred Qualifications
Recent and related experience working in health care marketing, member outreach and/or health education experience.
Experience working in call center environment

Education
Associate's degree or equivalent experience

Candidates must commit to duration of the project with the understanding that work hours can be varied. Due to proprietary information, candidates must inform employer if they are planning to accept employment with another MCO

Education
High School Diploma or equivalent


Notes
Fully remote (never coming onsite)
safety sensitive
Candidates must be able to work Monday – Friday. Must commit to Full-Time (40 hours a week) unless otherwise arranged.