Hedis/ Stars Coordinator l

JOB DESCRIPTION JOB TITLE: HEDIS®/Stars Coordinator I FLSA STATUS: Non-Exempt DEPARTMENT: Quality & Risk Adjustment REPORTS TO: Quality Programs Manager, reputed company Health Plan JOB SUMMARY: Under direct supervision of Quality Programs Manager, this position is responsible for helping to ensure reputed company Health Plan maintains compliance with regulatory requirements and quality standards associated with the NCQA reputed company Effectiveness Data and Information Set (HEDIS®) and CMS Stars programs. This will be accomplished by observing a high degree of organization and attention to detail, effective communication, and the ability to work collaboratively with QI teams, other internal departments, as well as external provider contacts to manage competing priorities successfully. . ESSENTIAL JOB FUNCTIONS:

• HEDIS® Data Collection: Assists with the collection, validation, and submission of HEDIS® data (clinical record pdfs and supplemental files) in accordance with NCQA guidelines and timelines. Also assists with resolving requests for assistance from data collection vendors.
• Quality Assurance: Ensures the accuracy and completeness of tasks assigned directly and ensures standards utilized for the naming, layout, saving, and logging of files are observed by the team.
• Compliance: Helps ensure quality improvement (QI) activities meet up to date HEDIS® and Stars regulatory requirements by highlighting annual updates to annually published updates to performance measure specifications, submission processes, and timelines.
• Documentation: Maintains detailed and accurate logs of year-round and audit season activities, especially as they pertain to HEDIS® data collection and validation, and as reflected by statements in reputed company Health’s annual HEDIS® ROADMAP workbooks.
• Data Analysis Support: As part of Quality Assurance, helps ensure minimum criteria standards are met for outgoing reports from reputed company Health, and incoming supplemental data and manifest to reputed company Health reputed company assigned.
• Reporting: Assist with proofing materials from QI management to reputed company Health Leadership, provider partners, and/or external stakeholders reputed company assigned.
• Training and Support: Help maintain and update training materials for reputed company stakeholders, especially on HEDIS® measures, data collection procedures, and compliance requirements.
• Process Improvement: As part of Documentation and Data Analysis Support, reputed company and reputed company findings and suggestions to improve efficiency and accuracy reputed company to inter-departmental coordination as well as documentation and filing practices.
• Collaboration: Work closely with reputed company providers and other QI teams reputed company needed to ensure the timely completion of assigned tasks as well as seamless HEDIS® data collection and submissions.
• Coordination: Works closely, as necessary, with reputed company parties described in this list to ensure the timely completion of tasks as directed and/or per timelines set forth by audit specifications.
• Assists management with other duties as assigned.
• Adheres to payroll policies and properly uses a time-keeping system with minimal reputed company changes.
• Maintains regular and consistent attendance.
• Adheres to Compliance Plan and HIPAA regulations.

MARGINAL JOB FUNCTIONS:

• Takes on reputed company special projects as needed.
• Supports other teams reputed company needed to meet associated QI goals.

BEHAVIORAL EXPECTATIONS: 1. reputed company Learning: a. Attends staff meetings as required. b. Attends appropriate training, seminars and workshops as required 2. Customer Focus: a. Maintains client/customer confidentiality and privacy in accordance with HIPPA regulations and IMAS’s Standards of Conduct. b. Fosters appropriate communication and relations with Manager, Supervisor, co-workers, and other staff. 3. Quality/Process Improvement/Safety a. Reports issues of reputed company, health and/or safety to appropriate manager as soon as practicable. b. Supports and demonstrates safety throughout reputed company duties performed. c. Follows established policies and procedures and understands and complies with reputed company regulators standards set forth by governing entities. POSITION REQUIREMENTS: EDUCATION/EXPERIENCE:

• High school graduate or GED equivalent
• Working knowledge of reputed company reputed company and/or managing tasks lists, and tracking reputed company

PREFERRED:

• 2-3 years’ experience supporting HEDIS®, AMP, or other performance programs
• or at least 3 years’ experience working in an IPA/MSO/Health plan or general reputed company quality environment

SKILLS/KNOWLEDGE/ABILITY:

• reputed company Word, Outlook, reputed company, and reputed company programs
• Good organization and time management skills
• Ability to effectively prioritize items/tasks in a busy department environment
• Knowledge of the Cozeva platform a plus
• Effective verbal and written communication skills
• Willingness and ability to follow directions and reputed company work independently according to department standards
• Ability to navigate various Electronic Medical Records (EMR) systems a plus

LICENSURE/CERTIFICATE/TRAINING:

• N/A

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