Pay Range: $59,000 - $116,000

Note: Individuals typically begin between the minimum to middle of the pay range

Assist with the planning, coordination, and execution of supplemental data strategies that support Healthcare Effectiveness Data and Information Set) HEDIS measure performance. Work as part of a quality team to support HEDIS measures across all lines of business.

• Bachelors degree and three years of related work experience; or equivalent combination of education and related work experience.

• Excellent verbal and written communication skills.

• Excellent presentation skills.

• Basic working knowledge of Microsoft Office applications including but not limited to Word, Excel, PowerPoint, and Outlook.

• Program and Project Support:
  
  • Coordinate ongoing collection, abstraction and organization of medical records and other documents that support HEDIS measure improvement, regulatory audits, and accreditation standards. Will include regular visits to provider offices.
  • Assist with the coordination of annual HEDIS data submission activities and adherence to deadlines (e.g., Roadmap submission, medical record review, audit).
  • Assist with oversight of contractors and vendors.

• Initiatives Development:
  
  • Apply detailed analysis and problem solving to research and recognize opportunities to improve HEDIS performance through data strategies.
  • Continuously develop and document quality improvement initiatives including procedures, resource requirements, deliverables, and expected and actual outcomes for each project phase.
  • Engage internal and external stakeholders, such as internal cross-functional teams, members, providers and community organizations, during project planning and implementation.

• Cross-functional Integration and Communication:
  
  • Work with HMSA departments and external partners to ensure coordination among groups.
  • Create, update and deliver written and verbal presentations to quality committee and other internal and external stakeholders.
  • Develop and lead internal and external trainings.
  • Develop and maintain relationships with provider offices and provider organizations to support successful collection of medical records.

• Administrative Support:
  
  • Support activities such as provider office visit scheduling and expense reimbursement requests.
  • Communicate with provider offices and provider organizations regularly via phone, email, fax and mail to request and receive medical records.

• Performs all other miscellaneous responsibilities and duties as assigned or directed.