HEDIS Health Services Facilitator

Be part of an Extraordinary Team

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Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.

We are looking for contract workers (via BCforward) who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact? 

Under the guidance of HEDIS leadership, this position is responsible for facilitating and completing HEDIS Quality Department-specific projects, ensuring consistency with company policies, values and goals in the annual process of gathering required medical records. In addition to serving as a role model in researching and contacting target providers, this individual serves as a facilitator and mentor to other HEDIS team members in achieving major segment component goals of the project and assists HEDIS leadership in setting and achieving tactical goals for successful completion of the project. This individual also serves as a contributor to and consultant for potential policy and procedural changes in the gathering and use of HEDIS data as well as the quality improvement process.

Primary duties may include, but not limited to:

• Facilitates annual HEDIS medical record collection and/or abstraction processes through successful implementation of target projects, such as large group medical record retrieval, coordination of copy services, implementation of invoicing processes, coordination of remote access record retrieval, specialized deep research assignments and other specific initiatives as identified and directed by HEDIS leadership.
• Serves as role model and inspiration to other HEDIS project Phone Team members through fast, efficient and professional practices in both researching and contacting/interacting with identified providers and other stakeholders.
• Acts as resource to other Phone Team members in conducting specialized deep research as needed to correctly identify appropriate providers from whom to request records.
• Collaborates as requested or needed with broader Team (e.g., abstractors, abstractor researchers, provider network management) in order to assist and support the identification and pursuit of required HEDIS data.
• Trains and mentors other Phone Team members, with guidance and support of leadership, in order to achieve goals of assigned projects, immediately alerting supervisor to any questions, issues or barriers that may be identified.
• Assists in the development of training materials, templates, processes, and procedures related to the project.
• Serves as functional liaison to leadership for multiple Phone Team members to complete special project assignments, ensuring that assignment-specific floor support and guidance is immediately available to those assigned In addition, this position must also generally support the HEDIS pursuit project in the following ways:
• AdministrativeWill be required to book appointments, verify information and communicate with provider offices making requests for medical record information, maintain department tracking logs, and support established administrative processes.
• Must maintain highest standards of ethics and ensure that all potential privacy incidents are verbally certified and then immediately reported to the HEDIS Leader for appropriate action

Requirements:

• High School diploma and 1 years of experience with HEDIS activity coordination and/or working within a Managed/Acute/Provider Care environment or an equivalent combination of education and experience.
• Basic Excel skills. Ability to type 30-40 WPM.
• Documented success in administrative organization and management.
• Basic project management skills and experience.
• Ability to learn and effectively use a variety of software programs to research information. Reliable transportation.
• Ability to commit to a project 4 - 4 ½ months long with no absences (barring documented emergencies).
• Ability to work in fast paced, production environment while maintaining pleasant, professional demeanor in interactions with providers and other customers as well as internal Team members.
• Ability to commit to working with no contact with outside environment during work hours (i.e., no phones, internet, iPods, other electronic devices)

Preferred:

• AD or BA/BS, NCQA and/or HEDIS experience.
• Documented success in administrative project management; CPM an added plus.
• Experience in production telephonic customer service environment.
• Successful experience in research and investigation using various software tools



BCForward is an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws.

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