HEDIS Outreach Coordinator

Our Client, a Retail Pharmacy company, is looking for a HEDIS Outreach Coordinator for their Remote location.

Responsibilities:

• 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.

Requirements:

• 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
• Recent and related experience working in health care marketing, member outreach and/or health education experience.
• Experience working in call center environment
• Verifyable High School Diploma or GED Required
• Associate's degree or equivalent experience

Why Should You Apply?

• Health Benefits
• Referral Program
• Excellent growth and advancement opportunities