Benefits:

401(k)

401(k) matching

Dental insurance

Health insurance

Vision insurance

Wellness resources

Responsible for performing duties to ensure HEDIS and STARs data gap closure, accuracy and reporting. Assist with quality initiatives in the service and clinical areas.

Duties and Responsibilities

1. Conduct provider outreach for specified groups to train and gather administrative and supplemental data to support HEDIS gaps.

2. Coordinate with provider staff schedule onsite record reviews.

3. Access Cozeva to continually monitor areas of improvement on HEDIS gap closure.

4. Create Power Point decks and other training material for providers and provider staff.

5. Coordinate quality initiative projects for various groups and perform follow up and outcome determination.

6. Download pull lists and perform provider/member outreach as required.

7. Responsible for formulating/implementing and executing all processes, requests, workflows or policies as requested by management in a courteous and efficient manner, including offering a proactive approach to suggestions and recommendations

8. Access various web portals to download medical records as needed

9. Troubleshoot record retrieval logistics with providers

10. Collaborate with health plan quality staff

11. Improvement activities to show trended year-to-year measurement growth

12. Actively participates in self-development programs

13. Attend health plan JOMs and other quality meetings

14. Attend on-site provider meetings to teach providers and staff about quality measures

Minimum Job Requirements

· High School graduate or GED equivalent; College degree preferred

· Minimum two-years experience working in a quality department in health plan or IPA environment

· Knowledge of HEDIS and medical record reviews

· Willing to travel locally to provider offices

Skill and Abilities

· Effective verbal and written communication skills and effective interpersonal skills.

· Excellent organizational skills and ability to multitask

· Ability to work well in a busy department

· Able to stay focused on the telephone even with noise and other distractions

This is a remote position.