HEDIS Coordinator (Remote Option-NC)

Office location: Remote/hybrid option; available for any of Partners' NC locations (or within 40 miles of NC border).

About the role

The HEDIS Coordinator's primary role is to ensure compliance with HEDIS standards, support quality improvement initiatives, and facilitate communication between departments. They assist Quality Advisors by providing essential data and coordinating appointments related to quality improvement activities. Overall, the HEDIS Coordinator plays a crucial role in enhancing patient outcomes and organizational success through meticulous data management and effective communication.

Responsibilities

• Ensure adherence to HEDIS standards by overseeing data collection, analysis, and reporting processes, including staying updated on HEDIS measures, guidelines, and regulatory requirements.
• Manage the collection, validation, and aggregation of data required for HEDIS and state reporting, coordinating with internal departments and external stakeholders.
• Collaborate with Quality Improvement teams to identify opportunities for improvement based on HEDIS data analysis and assist in developing and implementing quality improvement initiatives.
• Provide guidance to healthcare providers on proper documentation practices to accurately reflect patient care and meet HEDIS requirements, including interpreting and applying coding guidelines.
• Monitor performance metrics related to HEDIS measures, identify areas of concern or improvement, track progress toward goals, and report findings to relevant stakeholders.
• Conduct training sessions or workshops to educate staff and providers on HEDIS measures, data collection methods, and documentation requirements, providing ongoing support as needed.
• Act as a liaison between departments involved in HEDIS reporting and quality improvement efforts, facilitating communication and collaboration to ensure alignment of goals and strategies.
• Assist in preparing for annual PMV and HEDIS audits by ensuring all necessary documentation and data are accurate, complete, and readily accessible; participate in audit processes and address findings.
• Continuously evaluate processes and procedures related to HEDIS reporting and quality improvement, identifying opportunities to streamline operations, enhance efficiency, and improve data accuracy.

Requirements

• High School Diploma or equivalent (Associate or bachelor’s degree in healthcare administration, Health Information Management, or related field preferred).
• Minimum 3-5 years of experience in healthcare administration, medical records, or healthcare data management.
• Minimum 2 years of experience with healthcare quality measures or clinical data reporting.
• Experience with HEDIS measures, healthcare auditing, or quality improvement initiatives.
• Demonstrated experience working with healthcare providers and clinical documentation.
• Experience coordinating projects and managing multiple deadlines in a healthcare setting.
• Knowledge of HEDIS coding requirements.

Skills

• Knowledge:
  • In-depth understanding of Healthcare Effectiveness Data and Information Set (HEDIS) measures, including specifications, guidelines, and reporting requirements.
  • Knowledge of healthcare quality improvement principles, methodologies, and best practices.
  • Familiarity with medical coding systems (e.g., ICD-10, CPT) and healthcare documentation standards.
  • Understanding of regulatory requirements and compliance standards relevant to HEDIS reporting and quality improvement initiatives.
  • Knowledge of data collection, abstraction, and analysis techniques, including proficiency in data management tools and software used for HEDIS reporting.
• Technical Skills:
  • Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUP, data analysis functions).
  • Experience with healthcare databases and electronic health record systems.
  • Demonstrated ability to collect, validate, and analyze healthcare data.
  • Experience with project management and coordination of cross-functional teams.
  • Ability to interpret healthcare reports and identify data discrepancies.
  • Experience with SQL, SAS, R, or other data analysis software (preferred).
• Abilities:
  • Analytical skills: Ability to interpret complex data sets, identify trends, and draw meaningful conclusions to support quality improvement efforts.
  • Communication skills: Excellent verbal and written communication skills to effectively convey technical information, collaborate with stakeholders, and facilitate training sessions.
  • Organizational skills: Strong organizational and project management skills to coordinate HEDIS data collection, reporting, and quality improvement activities within established timelines.
  • Attention to detail: Meticulous attention to detail and accuracy in data collection, documentation, and reporting to ensure compliance with HEDIS standards.
  • Problem-solving skills: Ability to proactively identify issues, develop solutions, and implement corrective actions to address challenges encountered during the HEDIS reporting process.
  • Collaboration: Ability to work collaboratively with cross-functional teams, healthcare providers, and external stakeholders to facilitate HEDIS data collection and quality improvement initiatives.
  • Adaptability: Flexibility to adapt to changing priorities, organizational dynamics, and evolving regulatory requirements related to HEDIS reporting.
  • Time management: Strong time management skills to effectively prioritize tasks, manage competing priorities, and meet deadlines in a fast-paced healthcare environment.
  • Customer service orientation: Ability to provide support and guidance to healthcare providers and internal stakeholders, demonstrating a commitment to customer service and quality improvement.
  • Results-driven: Ability to drive results and achieve measurable outcomes in HEDIS reporting and quality improvement initiatives, including improving performance on HEDIS measures and closing care gaps.

Benefits

• Annual incentive bonus plan.
• Medical, dental, and vision insurance with low deductible/low cost health plan.
• Generous vacation and sick time accrual.
• 12 paid holidays.
• State Retirement (pension plan).
• 401(k) Plan with employer match.
• Company paid life and disability insurance.
• Wellness Programs.
• Public Service Loan Forgiveness Qualifying Employer.

See attachment for additional details.