HEDIS Coordinator
Listed on 2026-10-03
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Healthcare
Healthcare Compliance, Healthcare Administration, Healthcare Management, Health Informatics
Position Title: HEDIS Coordinator
Work Location: Remote, no specific state or time zone
Assignment Duration: 2 months potential to extend
Work Schedule: 8 hour work day, no OT M-F 8-5 in their time zone
Work Arrangement: Remote
Position Summary:
Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the service and clinical areas.
Background & Context:
We are needing assistance in Q4 to bring in more records to close HEDIS care gaps and review submitted records. We have a strong team that is very knowledgeable in HEDIS, but are needing extra assistance to pull and process records for Medicaid and Marketplace populations.
Key Responsibilities:
- Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results
- Establish and maintain an action plan to improve HEDIS scores
- Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities
- Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidences, documentations, and changes
- Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality
- Conduct quality audit and maintain all data and process controls to ensure compliance
- Performs other duties as assigned
- Complies with all policies and standards
Qualification &
Experience:
Education/Certification: Required: 3+ years in Quality Improvement/HEDIS. Preferred:
Bachelor's Degree.
Licensure: Required: NA. Preferred: (none).
Years of experience required:
Bachelor's degree in related field or equivalent experience. 3+ years of quality improvement or healthcare related experience. Working knowledge of the National Committee on Quality Assurance (NCQA). HEDIS requirements preferred.
Disqualifiers:
No knowledge or work history with HEDIS.
Additional qualities to look for:
Strong HEDIS measure experience, EMR experience.
Top 3 must-have hard skills stack-ranked by importance:
- HEDIS and EMR experience
- Microsoft Application experience, Excel
- Team collaborator and driven focus on task
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