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HEDIS and CARE GAPS

Suntree Internal Medicine
Melbourne, FL Full Time
POSTED ON 2/21/2025
AVAILABLE BEFORE 5/21/2025

Position

Hedis & Care Gap Specialist

FLSA Status

Hourly Non-Exempt

Reports to

Billing Supervisor

Shift

8 : 30am to 5 : 00pm

Reporters

Lunch

30 minutes

Wage : $15.00 / hr

Education :

High School Diploma or GED required

3 years of quality improvement or healthcare related experience required

Medical Terminology Knowledge required

Medical Experience required

Job Summary :

This position is responsible for assisting to ensure the highest percentage of member compliance for the department annual goals of HEDIS, STAR measures, CareGaps and Annual Wellness Visits for the contractual P4P and Value Based programs. This position also supports the development of patient-centered, team-based care.

Responsibilities :

  • Coordinate, complete and update management on all HEDIS processes and results.
  • Work closely with the CareGaps lead to organize and maintain a plan of action to improve HEDIS scores.
  • Works closely with our records department for all HEDIS requests.
  • Documents calls thoroughly in DASH system
  • Schedules preventative care appointments (e.g. : colonoscopies, mammograms, annual wellness visits)
  • Performs outbound scheduling phone calls for Commercial, and Medicare Quality Care
  • Communicates with providers and adds orders as needed
  • Facilitates lab requests for patients who are missing lab results and data; directs patients to closest facility
  • Provides patient education professionally by phone or email
  • Facilitates orders and notification practices
  • Communicates / records results into EMR system
  • Makes follow-up phone calls for all no shows and cancellations within the realm of annual wellness visits, mammograms, and colonoscopies
  • Create / Runs point of care reports daily and sends them to administration for care gap closure at the time of service.

Abilities :

  • Exceptional Customer Service skills
  • High-level of multi-tasking
  • Time management skills
  • Team player
  • Ability to manage tasks with minimal supervision
  • Physical Requirements :

  • Requires full range of body motion including handling and lifting of patients, manual and finger dexterity, and hand-eye coordination.
  • Requires sitting, standing and / or walking for extensive periods of time
  • Occasionally lifts and carries items weighing up to fifty (50) pounds
  • Requires corrected vision, hearing, and speech within normal ranges
  • Requires working under stressful conditions and sometimes irregular hours
  • About Suntree Internal Medicine :

    We are a large private internal medicine practice located in Melbourne, Florida. We are an equal opportunity employer and we believe that education and training are a key part of success. Our values are to bring Sincerity, Inspiration, and Mastery into the workplace. We offer benefits, paid time off, and holidays after the 90-day probation period review.

    Salary : $15

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    Job openings at Suntree Internal Medicine

    Suntree Internal Medicine
    Hired Organization Address Melbourne, FL Full Time
    Position Billing Specialist FLSA Status Hourly Non-Exempt Reports to Billing Manager Shift 8am to 4:30pm Reporters 0 Lun...

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