HEDIS Coordinator (Medicare) 3.3 3.3 out of 5 stars 806 S Douglas Rd, Coral Gables, FL 33134 Hybrid work Up to $25 an hour
- Full-time Genuine Health Group LLC 4 reviews Up to $25 an hour
- Full-time Summary The HEDIS/Quality Improvement Coordinator performs a key role in ensuring healthcare providers excel in meeting Quality Measures consistent with the CMS Star Rating Program.
This position is responsible for medical record reviews, audits, and performance tracking for several providers as assigned. Works closely with each provider to educate and identify areas of improvement ensuring compliance with regulatory guidelines. This position will require strong organization, communication skills, and feedback to achieve maximum CMS Star Ratings every year. Assists with other clerical duties as required. Minimum Education and Experience Some college, plus two years of related professional work experience, or equivalent combination of education and experience. Two years of related healthcare experience working with
ICD 9/10
codes and EMR's. Basic knowledge and understanding of Medicare HEDIS projects (Part C and Part D) Bilingual (English and Spanish) required to provide provider education training Two years of proven ability to use MS Office and perform diverse clerical functions within a professional work environment. Work Schedule Monday to Friday
- 8:30AM to 5:30PM EST Road travel required
- 25% Field Travel within Miami-Dade and Broward counties Hybrid Schedule
- on-site/in-person 2x per month Essential Duties and Responsibilities Engages physicians and office staff to facilitate discussions on medication adherence, prescription refills and other metrics relevant to HEDIS Part D, aiming to gather comprehensive patient data.
Performs medical record reviews, abstraction and data-entry for HEDIS as part of HEDIS operations. Prepares reports and presentations outlining progress findings, and recommendations for management or regulatory bodies. Conducts monthly reviews in a timely manner and in accordance with established guidelines. Tracks compliance issues, trend data, prepares regular reporting to enhance performance related to HEDIS measures, and distributes to providers and internal teams. Stays informed about the
HEDIS/STAR
rating requirements and applicable annual updates. Prepares, submits, and bill findings to external stakeholders, ensuring adherence to reporting deadlines. Presents a summary of all tracking reports to identify areas of improvement monthly or upon request. Road travel required
- 25% (Miami-Dade and Broward Counties) Performs other related duties as assigned.
Knowledge, Skills and Abilities Strong organizational skills with keen attention to detail Ability to handle time-sensitive information, manage priorities and workflow. Excellent verbal and written communication skills. Proven customer service skills and demonstrated ability to deal effectively with a diversity of individuals. Versatility, flexibility, and a willingness to work within constantly changing priorities with enthusiasm. Proficient in Microsoft 365: Word, Excel, PowerPoint, Outlook and Teams. Proven ability to handle multiple projects and meet deadlines. Genuine Health Group offers a competitive compensation and benefits package that includes a 401k matching program, fully subsidized medical plans, paid holidays and much more. Base salary will be commensurate to professional experience. Genuine Health Group is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.
Job Type:
Full-time Pay:
Up to $25.00 per hour
Benefits:
401(k) 401(k) matching Dental insurance Employee assistance program Employee discount Flexible spending account Health insurance Health savings account Life insurance Paid time off Parental leave Referral program Retirement plan Tuition reimbursement Vision insurance Application Question(s): Will you now or in the future require visa sponsorship to work in the United States? Briefly describe your hands-on experience with HEDIS reporting or chart review. What are your salary expectations?
Education:
Associate (Preferred)
Experience:
EMR systems: 1 year (Required) HEDIS Stars ratings and measures: 1 year (Required) clinical quality metrics: 1 year (Required)
Language:
English and Spanish (Fully Bilingual) (Required) Willingness to travel: 25% (Required)
Work Location:
Hybrid remote in Coral Gables, FL 33134
