What are the responsibilities and job description for the HEDIS Coordinator position at MW Partners?
Job Description:
Functions & Job Responsibilities
- Candidate will work with the Stars and Risk team to collect member records and conduct reviews of these records by contacting providers and placing the results collected into a specific database.
- Facilitate fax or telephone call notification for providers utilizing reports.
- Create PowerPoint decks and other training materials for providers and staff.
- Collects and compiles the required documentation to maintain critical quality improvement functions.
Telephonic and electronic outreach to patients
- HIPAA compliant outreaches to patients for Medication adherence/utilization and other risk/quality gaps closure support including but not limited to CAHPS and HEDIS/Risk gaps.
- Conducts member outreach for quality initiatives including HEDIS or wellness care gaps, medication adherence, member experience, Health Risk assessments, and other quality related outreach campaigns.
- May also be required to conducts member outreach from provider office as needed.
- Warm transfer of any calls to the vendors per the need of the project.
- Identifying barriers that prevent patients from closing any gaps and work with care team members to help patients be successful in managing their health.
- Coordinate with members of the patient care team, including vendors, providers, pharmacists, nurses, and patient care coordinators to address patient needs.
- Other duties as assigned.
Qualifications
Education and Experience:
- EMR experience is a plus, must be okay with travel to provider offices.
- Minimum two (2) years' experience in health plan, managed care or equivalent experience.
- Knowledge of CMS Star Programs, HEDIS is a plus.
- Valid driver’s license, reliable transportation, and insurance required with clean driving record
Skills:
- Prior experience with project coordination and timelines
- Demonstrated effective organizational skills.
- Excellent communication, writing, proofreading and grammar skills
- Strong proficiency with MS Word, Excel, Power Point
- Excellent organizational skills and attention to detail
- Knowledge of HEDIS technical requirements is a plus