HEDIS Coordinator – Putnam County

Job Description

Position Summary

The Healthcare Effectiveness Data and Information Set (HEDIS) Coordinator ensures as many of the HEDIS quality measures are met by the end of the calendar year.  The coordinator alerts Clinical Providers to unmet quality metrics to encourage the patient schedule the screenings.  In addition, the coordinator provides educational support regarding the quality metrics.

Essential Duties and Responsibilities

The essential functions include, but are not limited to the following:

• Review patient chart for documentation of completed screenings. Review progress notes, consultations, and hospital discharge records.  Update HEDIS checklist to alert Clinical Provider of the needed screenings.
• Send patient a letter identifying the personalized screenings recommended by the year end.
• Receive patient inquiries and provide information to patients on these screenings; Assist with the screening scheduling as needed.
• Assist in the distribution of HEDIS reports to Office Managers.
• Ensure offices have Functional Status templates in the chart of patients enrolled in Special Needs Plans (SNP).
• Must stay current on HEDIS education and CMS updates. Must be able to understand and explain HEDIS spreadsheets with CPT codes to office staff as needed.
• Must attend all Humana HEDIS related meetings and trainings.
• Work on other HEDIS projects as assigned.
• Perform other duties as assigned.

Minimum Qualifications (Knowledge, Skills, and Abilities)

• High School graduate or equivalent required.
• 1-year medical office experience required.
• Microsoft Office experience preferred.
• Must possess excellent communication skills including telephone skills.
• Ability to stay focused and give great attention to detail.

Physical Demands and Work Environment

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this position. Reasonable accommodations may be made to enable individuals with disabilities to perform the functions.

While performing the duties of this position, the employee is regularly required to talk or hear. The employee frequently is required to use hands or fingers, handle or feel objects, tools, or controls. The employee is occasionally required to stand; walk; sit; and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this position include close vision, distance vision, and the ability to adjust focus. The noise level in the work environment is usually low to moderate.

Note

This job description in no way states or implies that these are the only duties to be performed by the employee(s) incumbent in this position. Employees will be required to follow any other job-related instructions and to perform any other job-related duties requested by any person authorized to give instructions or assignments. All duties and responsibilities are essential functions and requirements and are subject to possible modification to reasonably accommodate individuals with disabilities. To perform this job successfully, the incumbents will possess the skills, aptitudes, and abilities to perform each duty proficiently. Some requirements may exclude individuals who pose a direct threat or significant risk to the health or safety of themselves or others. The requirements listed in this document are the minimum levels of knowledge, skills, or abilities. This document does not create an employment contract, implied or otherwise, other than an “at will” relationship.

The company is an Equal Opportunity Employer, drug free workplace, and complies with ADA regulations as applicable.