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HEDIS Specialist (Quality Improvement Coordinator)

UNIVERSITY FAMILY HEALTHCARE P.A
Sarasota, FL Full Time
POSTED ON 3/6/2025
AVAILABLE BEFORE 5/6/2025

University Family Healthcare is looking for a HEDIS coordinator to join our health team! The successful candidate needs to be reliable, trustworthy, motivated, a problem solver, and able to work independently and in a team environment.

Essential job functions

  • Assists with various aspects of the HEDIS process
  • Perform medical chart reviews to look for gaps in care such as missing mammograms, colon cancer screenings, diabetic screenings, etc.
  • Track open quality gaps
  • Coordinate with clinical staff to inform them of missing screenings and HEDIS gaps
  • Download patient records and upload them to insurance portals to close quality gaps.
  • Track inpatient and emergency room discharges and collect medical records from the corresponding healthcare facilities
  • Fax release of information requests to necessary healthcare facilities
  • Work with an automated system to upload records to patient charts
  • Keep a log of inpatient and emergency room discharges
  • Coordinate with clinical staff to inform them of patient hospital and emergency room utilization so proper follow-up steps can be taken by the clinic
  • Contacts patients for appointments related to HEDIS non-compliance measures as needed
  • Reliable attendance and presence at work
  • Perform other work-related duties as assigned

Education and Experience

  • High School Diploma Required
  • At least one (1) year of experience in HEDIS or a related field is a plus
  • Strong knowledge of Microsoft Office Suite (Excel- basic mathematical formulas, charts, tables)
  • Knowledge of CPT/ICD-9 & 10 & Medical Terminology

Performance requirements

  • Knowledge of NCQA HEDIS measures
  • Goal-oriented, self-motivated, organized, team player, problem solver, etc.
  • Aware of HIPAA rules regarding patient health information security
  • Ability to meet and manage deadlines
  • Medical background is a plus

Qualifications

  • Driver's License

Job Type: Full-time

Pay: $18.00 - $19.00 per hour

Expected hours: 40 per week

Benefits:

  • Dental insurance
  • Health insurance
  • Life insurance
  • Paid time off
  • Vision insurance

Schedule:

  • 8 hour shift
  • Monday to Friday

Experience:

  • HEDIS: 1 year (Required)

Ability to Commute:

  • Sarasota, FL 34240 (Required)

Ability to Relocate:

  • Sarasota, FL 34240: Relocate before starting work (Required)

Work Location: In person

Salary : $18 - $19

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