HEDIS Outreach Coordinator

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

📋 Description

• Act as a subject matter expert in the enhancement of HEDIS initiatives.

• Engage with providers and/or members to improve healthcare outcomes, focusing on preventive care compliance.

• Facilitate provider engagement and actively participate in workgroups.

• Provide high-quality information to both internal and external stakeholders through effective written and verbal communication.

• Identify opportunities for process improvements and develop efficient workflows.

• Independently devise and implement provider outreach work plans and deliverables.

• Manage complex relationships with both internal and external stakeholders.

• Offer consultation on solutions to business challenges, education, and opportunities for process improvements.

• Assist provider partners in addressing HEDIS gaps in care, digital solutions, discussions on remote medical record collection, and educational efforts.

• Collaborate with provider partners to strengthen coordination with Aetna.

• Support HEDIS quality initiatives and ensure compliance with regulatory and contractual requirements, including outreach to noncompliant members.

• Assist in the medical record capture for HEDIS medical record review and the abstraction of supplemental data.

• Participate in public speaking engagements.

⛳️ Requirements

• A minimum of 3 years of recent and relevant healthcare experience in any setting.

• At least 1 year of experience in Medicare and/or 1 year of experience in HEDIS medical record abstraction.

• A minimum of 1 year of experience in member/provider education focusing on gaps in care.

• Proven ability to perform successfully in an environment with daily/weekly productivity expectations.

• Capability to work independently.

• Proficiency in using standard corporate software packages and applications.

• Excellent communication skills.

• Experience interacting with medical providers and/or medical office staff.

• Recent and related experience with HEDIS.

• Background in Medicare Stars or health insurance.

• Relevant healthcare experience in clinical, managed care, or quality management settings.

• Familiarity with CPT/CPTII/ICD9/ICD10 coding and medical terminology.

• Bachelor’s Degree or equivalent experience in healthcare.

🏝️ Benefits

• Medical coverage.

• Dental coverage.

• Vision coverage.

• Paid time off.

• Retirement savings options.

• Wellness programs.

• Additional resources supporting physical, emotional, and financial well-being.

• Eligibility for CVS Health bonus, commission, or short-term incentive programs.