HEDIS Chart Reviewer/ Care Coordinator- Remote

Job Title: Care Coordinator

Location: Remote
Duration: Contract – 6 months
Pay Range: $23.00/hr (W2)

Schedule: M-F: 8.00am to 5.00pm CST

Must Have:

• Experience reviewing healthcare, medical, clinical, care management, or LTSS documentation.
• Experience with healthcare record review, auditing, compliance reviews, or medical record abstraction, including interpreting documentation and applying defined criteria consistently.
• Experience with LTSS, Medicaid, HCBS waivers, utilization management, quality, or HEDIS.
• Familiarity with care plans, assessments, and care management documentation.
• Experience with chart chase, HEDIS chart review, or clinical abstraction.
• Strong attention to detail, documentation accuracy, organized follow-up, and ability to maintain accurate records.
• Ability to manage a high-volume workload, meet deadlines, and prioritize multiple tasks.
• Proficiency with Microsoft Excel, Outlook, Teams, and electronic health/record systems.
• Ability to protect confidential member information and follow HIPAA/privacy requirements.

Purpose:

• Support Sunflower Health Plan's LTSS HEDIS chart chase by reviewing and auditing LTSS care management records, identifying required documentation, and participating in chart retrieval and abstraction activities. Maintain accurate tracking of chart status and audit findings, follow established HEDIS and confidentiality requirements, and escalate documentation gaps or barriers to LTSS leadership.

Day to Day

• Schedule: Monday-Friday, 8:00 AM-5:00 PM Central Time; overtime only if approved and needed to meet project deadlines.
• Review assigned LTSS care management records against established HEDIS chart chase criteria and audit guidance.
• Locate, organize, and validate supporting documentation in approved systems.
• Document chart status, findings, gaps, and follow-up needs in the designated tracker or workflow.
• Participate in chart chase activities and coordinate with LTSS care management, quality, and other internal partners.
• Escalate missing records, access barriers, or unclear documentation to the designated lead.
• Remote, non-member-facing role with regular virtual team communication and independent production work.

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