HEDIS EDUCATOR

This position is work from client office and requires travel to providers practices. The HEDIS Outreach Educator under the guidance of the Director of Quality and Star Programs oversees, plans, and implements new and existing healthcare quality improvement initiatives and education programs; ensures maintenance of programs for providers and members in accordance with prescribed quality standards; presents front office training programs, conducts data collection, reporting and monitoring for key performance measurement activities at the provider and member level; and provides direction and implementation of NCQA accreditation surveys and federal/state QI compliance activities. Conducts HEDIS audits, site reviews, and medical records reviews. - In partnership with the PCP, evaluates the results of the initial assessment. Establishes a project plan with the practice that establishes goals and objectives for improvement. - Provides ongoing practice support and sustains the partnership. - Establishes regular meetings to track progress.

Experience:

• HEDIS auditing and coding: 3 years (Preferred)
• healthcare: 3 years (Preferred)

Qualifications

Education:

· Bachelor's Degree or equivalent combination of education and work experience.

· Certified Coder

Experience:

· Min. 3 years' experience in healthcare with minimum 2 years' experience in health plan quality improvement, managed care or equivalent experience.

· 2 years provider relations and HEDIS chart auditing and coding experience.

Job Duties and Responsibilities

The HEDIS Outreach Educator contributes to one or more of these quality improvement functions:

o Quality Interventions and Quality Improvement Compliance.

o Acts as a lead specialist to provide project-, program-, and / or initiative-related direction and guidance for other specialists within the department and/or collaboratively with other departments. Implements key quality strategies, which may include initiation and management of provider, member and/or community interventions (e.g., removing barriers to care);

o preparation for Quality Improvement Compliance surveys; and other federal and state required quality activities.

· Monitors and ensures that key HEDIS activities are completed on time and accurately in order to present results to key departmental management and other departments as needed.

· Writes educational programs to educated and interpret program and measurement specifications, explain programs, share best practices and member engagement strategies, and records results of programs, and document findings and limitations of engagement interventions.

· Creates, manages, reviews, and/or compiles the required documentation to maintain critical HEDIS quality improvement functions.

· Leads HEDIS quality improvement activities, meetings and discussions with and between other departments within the organization.

· Evaluates project/program activities and results to identify opportunities for improvement.

· Surfaces to Director any gaps in processes that may require remediation.

· Other tasks, duties, projects and programs as assigned

Job Types: Full-time, Contract

Pay: $18.00 - $23.00 per hour

Schedule:

• 8 hour shift

Ability to commute/relocate:

• Houston, TX 77018: Reliably commute or planning to relocate before starting work (Required)

Experience:

• HEDIS: 1 year (Required)

Work Location: One location