Hedis Coordinator Jobs in Riverside, CA (NOW HIRING)

Job Title: Quality Improvement Coordinator

Target Compensation Range: $23.00-$26.00/hour, depending on relevant qualifications and experience

About Us:

Astiva Health, Inc., located in Orange, CA is a premier healthcare provider specializing in Medicare and HMO services. With a focus on delivering comprehensive care tailored to the needs of our diverse community, we prioritize accessibility, affordability, and quality in all aspects of our services. Join us in our mission to transform healthcare delivery and make a meaningful difference in the lives of our members.

Summary:

The Quality Improvement Coordinator will be responsible for coordinating and implementing quality improvement initiatives related to HEDIS measures and risk adjustments/HCC. This individual will work with internal and external stakeholders to ensure compliance with HEDIS specifications, data collection, reporting, and improvement strategies.

ESSENTIAL DUTIES AND RESPONSIBILITIES include the following:

• Coordinate and partner with IPA/MSO delegates for HEDIS and risk adjustment data reporting.
• Identify gaps and opportunities for improvement.
• Collaborate with internal departments to review and implement projects and interventions to improve delivery of services and quality of care.
• Assist with audits and reviews to ensure data accuracy and validity.
• Review and summarize collected data with trend analysis for additional provider educational opportunities.
• Attend health plan meetings as requested by department leadership.
• Stay updated on HEDIS and risk adjustment specifications, guidelines, and industry trends.
• Regular and consistent attendance
• Other duties as assigned

EDUATION and/or EXPERIENCE:

• Bachelor's Degree preferred
• 3+ years of quality improvement or healthcare related experience
• Familiarity of HEDIS measures, specifications, and reporting requirements
• Proficient in data analysis, Excel, and quality improvement methodologies
• Excellent communication, presentation, and interpersonal skills
• Ability to work independently and collaboratively in a fast-paced environment.
• Detail-orientated, organized, and problem-solving skills.
• Fluent in Vietnamese (verbal and written)

Benefits:

• 401(k)
• Dental insurance
• Health insurance
• Life insurance
• Paid time off
• Vision insurance

LANGUAGE: Ability to read and interpret documents such as safety rules, operating and maintenance instructions, and procedure manuals. Ability to write routine reports and correspondence. Ability to speak effectively before groups and customers or employees of the organization.

MATHEMATICS: Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to compute rate, ratio, and percent and to draw and interpret bar graphs.

REASONING ABILITY: Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form.

EEO/AFFIRMATIVE ACTION STATEMENT: It is the policy of Astiva Health to provide equal employment opportunities without regard to race, color, religion, sex, national origin, age, disability, marital status, veteran status, sexual orientation, genetic information or any other protected characteristic under applicable law. This policy relates to all phases of employment, including but not limited to recruiting, employment, placement, promotion, transfer, demotion, reduction of workforce and termination, rates of pay or other forms of compensation, selection for training, the use of all facilities, and participation in all company sponsored employee activities. Provisions in applicable laws providing for bona fide occupational qualifications, business necessity or age limitations will be adhered to by the organization where appropriate. Please refer to Standard Operating Procedure 100 for more information about the organization’s Affirmative Action/EEO statement.

PHYSICAL DEMANDS: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is frequently required to sit and complete work while on a computer. The employee occasionally is required to stand, walk, use hands to finger, handle or feel, reach with hands and arms, stoop, kneel, crouch or crawl, climb or balance, talk and hear. While performing the duties of this job, the employee is occasionally required to lift or exert force up to 10 pounds.

WORK ENVIRONMENT: The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions. The noise level in the work environment is usually moderate.