HEDIS & Quality Coordinator
Bond Clinic Winter Haven, FL
- Expired: over a month ago. Applications are no longer accepted.
General Summary of Duties: Responsible for reviewing and analyzing data and ensuring HEDIS & Quality measure compliance. This position will be responsible for overseeing the specific strategic and tactical initiatives designed to achieve and maintain a 4 - 5 Medicare star rating and HEDIS rating standards.
Examples of Duties: (This may not include all of the duties assigned)
Works HEDIS programs and projects that enable Bond Clinic to measure, monitor, and improve the quality of the care and service provided to its members
Provides expertise and supports the organization's strategies and initiatives related to HEDIS.
Works with MSO partners to obtain data needed to track and trend quality metrics.
Lead projects to increase physician and patient awareness. Implement, improve, and measure medical group and physician-level improvement(s) including opportunities and strategies to optimize physician and patient outcomes.
Ensures proper compliance with regulatory agencies and demonstrates current knowledge and remains current in fields associated with HEDIS regulations.
Provides direction and leadership, with accountability for HEDIS program(s), projects, and initiatives.
Train, advocate, and teach other clinical departments the importance of quality care in relation to HEDIS activities.
Review of data in developing plans to achieve goals.
Perform accurate and comprehensive reviews of medical records to ensure HEDIS measure compliance.
Keep log accurate and report of findings from chart audits; identifies opportunities for improvement based on results.
Ensures maintenance of accurate documentation for quality improvement activities such as HEDIS reporting, surveys, audits, peer reviews, etc.
Upload data, compliant patient forms, and/or fax to insurance companies.
Tracks requests sent out and medical records received.
Contacts patients for appointments related to HEDIS
Advises management of possible trends in inappropriate utilization (under and/or over), and other quality of care issues.
Adheres to patient confidentiality protocol.
Performs other duties as assigned.
Education: Bachelor's degree required and/or equivalent training and experience.
Experience: Required 5 years of experience in managed care, HEDIS, STARS, and/or other healthcare initiatives Minimum Experience: Health plan or Medical Group experience with day-to-day operations; experience in a physician group model. Computer experience required.
Certificate/License: Certified Coder, CMA, LPN, RN preferred, but not required if experienced.
Bond Clinic is a Drug-Free Workplace and an Equal Opportunity Employer. Bond Clinic will provide reasonable accommodation to complete the online application consistent with applicable law. If you require an accommodation, please contact Human Resources.
AddressWinter Haven, FL
ManufacturingView all jobs at Bond Clinic