HEDIS Outreach Coordinator

SGS_JOB_2382

Admin/Clerical
Remote
HEDIS
Customer Service
Call Center
Inbound/ Outbound
medical record
Healthcare Data

Contract - Contract (mandatory): 06+ Months

Provides support for Healthcare Effectiveness Data and Information Set (HEDIS) quality initiatives and regulatory/contractual requirements including outreach to members who are noncompliant in the designated outreach services

Job Responsibilities:

  • Supports effective medical record capture for HEDIS medical record review and abstraction of supplemental data.
  • Performs provider/location research, clean up, and data updates to ensure that medical record requests are submitted to the right location and PHI is properly handled
  • Conducts HEDIS provider chart request calls, faxes, and mailings.
  • Identifies potential resources and initiates collaboration with providers to improve member health outcomes and HEDIS measure rates
  • Facilitates provider and member outreach to ensure member receipt of important clinical services to improve member health outcomes and close gaps in care.
  • Identifies when to refer member to Social Worker or Case Manager.
  • Assists in the development and standardization of outreach documentation and manages the data flow process to complete HEDIS documentation.
  • Documents member participation in outreach activities in accordance with abstraction and audit standards.
  • Records and documents all members and provide outreach activity.

Skills:

  • Minimum 1 year, recent HEDIS project support-related experience
  • Strong communication skills and experience speaking with medical providers.
  • Ability to use standard corporate software packages and corporate applications.
  • Computer skills: Microsoft Word, Excel, Outlook, Teams, Adobe Reader, RightFax
  • Recent and related experience working in health care marketing, member outreach and/or health education experience.
  • Experience working in call center environment

Education/Experience:

  • Associate degree or equivalent experience

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