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 (Healthcare 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. • Perform 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 all data and process controls to ensure compliance. • Maintains interdepartmental lines of communication. • Assists in setting up all 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 when 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 MS Word, Excel, 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, Excel, 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 educate and train compliance and clinical standards to staff members. • Must be able to travel as needed. • Ability to effectively elicit/provide information to and from appropriate individuals (including, but not limited to, supervisors, co-workers, patients) via strong communication skills. This offer from "DAP Health" has been enriched by Jobgether.com and got a 74% flex score. Apply Job! Apply to this Job