HEDIS Operations Coordinator

This is a fully remote position, open to applicants in Maine.

📋 Description

• Act as the main point of contact for vendors involved in medical record retrieval.

• Oversee daily operational tasks that support HEDIS and quality program goals.

• Manage vendor contracts, which includes new agreements, renewals, amendments, and terminations.

• Investigate and address issues and complaints related to vendors.

• Track corrective action plans and work with stakeholders to enhance vendor performance.

• Organize the procurement of medical records, including requests, retrieval status, receipt tracking, and inventory management.

• Reconcile and verify vendor invoices in collaboration with Accounts Payable and Quality leadership.

• Communicate effectively with provider offices, facilities, and record custodians to ensure prompt record retrieval.

• Maintain operational reports, dashboards, and documentation.

• Assist in HEDIS audit readiness, submission inventories, audit requests, and regulatory activities.

• Coordinate cross-departmental quality initiatives and operational projects.

• Provide regular status updates to leadership.

• Perform additional duties and responsibilities as required.

⛳️ Requirements

• Bachelor's Degree or an equivalent combination of relevant education and experience.

• Minimum of 3 years of experience in a healthcare or managed care organization is required.

• Experience with health plan quality is preferred.

• Familiarity with medical terminology, healthcare documentation, and fundamental financial tracking processes.

• Proficient in Microsoft Office applications, particularly Excel, Word, and PowerPoint at an intermediate level or higher.

• Medical Assistant Certification is preferred.

• PMP/PMI certification is preferred.

• This position is not eligible for immigration sponsorship.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Retirement savings plan with employer contributions.

• Paid time off.

• Volunteer time off.

• Pie day.

• Additional employee benefits.

• Potential for extra incentive or commission-based compensation, where applicable.