HEDIS Coordinator
Core
Coordinate data acquisition, validation, and reporting processes to enhance electronic clinical data availability for DHP Quality performance metrics.
Role type
HEDIS Coordinator
Builds
Quality data reporting and performance metrics initiatives
Domain
Health insurance / Quality measurement
Deliverable
dashboards & analysis
Required skills
Data validation, stakeholder liaison, project management, regulatory compliance, training material development, analytics application, data integration coordination, industry standards knowledge
Preferred skills
NCQA specifications knowledge, HEDIS audit process experience, Medicaid/Medicare benefit program experience
Technologies
Microsoft Office, Electronic Clinical Data Systems (ECDS), Provider Performance Platform, Health Information Exchanges (HIE)
Responsibilities
Develop and implement business and technical processes to acquire and validate external provider data; Lead project management of complex clinical data acquisition activities; Partner with stakeholders to ensure compliance with regulatory and contractual requirements for HEDIS audits; Apply analytics to identify specific populations/providers for quality interventions; Facilitate integration of clinical data from aggregators and internal sources; Maintain knowledge of NCQA and HEDIS technical specifications
Seniority
Individual Contributor
