HEDIS Coordinator (TEMP)

Job Number: 1410

Workplace Type:

Position Title: HEDIS Coordinator

External Description:

Position Summary

The temporary HEDIS Coordinator is responsible for supporting HEDIS data collection and chart retrieval for the annual NCQA health plan audit. This individual will perform medical record collection, reviews, and abstract data to support compliance with HEDIS measure sets.

General Duties Responsibilities
(May include but are not limited to)

• Retrieve medical record supporting documentation, which may include outbound calls to provider offices, scanning charts, and downloading files from EMR or other health plan systems. 
• Assist vendor performing chart collection for AHC with any issues (“pends”) by performing additional research or outreaching to provider offices to address any issues. 
• Review, locate, and abstract measure-specific clinical data from medical records for documentation supporting HEDIS gap closure.
• Ensure all abstracted data meets documentation guidelines by applying NCQA’s technical specifications.
• Follow standard departmental processes, policies, and procedures with regards to performing abstraction and coding activity.
• Ensure patient privacy is protected by adhering to HIPAA standards, company policies and procedures, and other federal, state, and local requirements.
• Assist with other HEDIS initiatives, as required by the department.

Supervisory Responsibilities

This position has no supervisory responsibilities.

Minimum Requirements

1. Minimum Experience:
2. • 1 year of healthcare industry experience required (health plan, managed care, medical group / IPA, or provider office preferred)
   • Experience in HEDIS / STAR, or other quality area preferred.
   • Experience in member services (health plan, managed care, or medical group / IPA) preferred.
3.  Education / Licensure:
4. • High school diploma or general education degree (GED) required
   • Certified coder (CPC, CCS, CCS-P, CRC, COC, CPC-P, RHIT or RHIA Certification) preferred.
5. Other:
6. • Excellent customer service and phone skills.
   • Proficient in Microsoft Excel.
   • Knowledge of medical terminology and HIPAA.
   • Strong attention to detail, problem-solving, and analytical skills are essential.
   • Self-starter; able to work independently with minimal supervision.
   • Strong communications skills: written, verbal, and interpersonal

Essential Physical Functions

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.

1. While performing the duties of this job, the employee is regularly required to talk or hear. The employee regularly is required to stand, walk, sit, use hand to finger, handle or feel objects, tools, or controls; and reach with hands and arms.
2. The employee frequently lifts and / or moves up to 10 pounds. Specific vision abilities required by this job include close vision and the ability to adjust focus.

City: Orange

State: California

Location City: Orange

Location State: California

Community / Marketing Title: HEDIS Coordinator (TEMP)

Company Profile:

By leveraging our world-class technology platform, innovative care delivery models, deep physician partnerships and our serving heart culture, Alignment Health is revolutionizing health care for seniors! From member experience professionals and clinicians, to data scientists and operations leaders, we have built a talented and passionate team that is deeply committed to our mission of transforming health care for the seniors we serve. Ready to join us?

At Alignment, delivering exceptional care to seniors starts with ensuring an exceptional experience for our over 1,300 employees. At the center of our employee experience is a culture where employees at all levels and across all teams are encouraged to share their unique ideas and perspectives. After all, when you can bring your authentic self to work, whether that’s in a clinical setting, our corporate office or a home office, creativity and innovation flourish! Another important part of the Alignment culture is a belief in continuous learning and growth. As a result, in this fast-growing company, you will find ample support to grow your skills and your career – with us.

EEO Employer Verbiage:

 

Please note: All clinical positions are contingent upon successful engagement with Alignment Health’s COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

Alignment Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity, or sexual orientation.

*DISCLAIMER: Please beware of recruitment phishing scams affecting Alignment Health and other employers where individuals receive fraudulent employment-related offers in exchange for money or other sensitive personal information. Please be advised that Alignment Health and its subsidiaries will never ask you for a credit card, send you a check, or ask you for any type of payment as part of consideration for employment with our company. If you feel that you have been the victim of a scam such as this, please report the incident to the Federal Trade Commission at https://reportfraud.ftc.gov/#/. If you would like to verify the legitimacy of an email sent by or on behalf of Alignment Health’s talent acquisition team, please email [email protected].