Job Summary:
Under direct supervision of the Director of Quality and Population Health, the position assists in coordination of overall HEDIS (Healthcare Effectiveness Data and Information Set) activities. Responsible for providing operational/strategic support in planning, coordinating, and validating HEDIS.
Hybrid Requirement: This position will regularly travel to DAP Health Clinics in San Diego county.
Supervisory Responsibilities: N/A
Essential Duties and Responsibilities:
- Meets the organization’s customer services standards, including interpersonal communication and professional conduct expectations.
- Assists with various aspects of the HEDIS process.
- Perform medical chart reviews to look for gaps in care such as missing mammograms, colon cancer screenings, diabetic screenings, etc.
- Track open quality gaps.
- Coordinates with clinical staff to inform them of missing screenings and HEDIS gaps.
- Coordinates HEDIS processes and establishes a plan to improve scores.
- Implement a process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities.
- Conduct quality audits.
- Coordinating HEDIS activities for internal departments, external partners, and contracted vendors.
- Manages HEDIS reporting process across the organization.
- Maintain all data and process controls to ensure compliance.
- Maintains interdepartmental lines of communication.
- Assists in setting up all performance improvement activities across the organization.
- Prepare HEDIS findings for CQI committee so that CQI can consider and enact clinical risk recommendations to address quality issues and mitigate further legal risk exposure.
- Provides weekly data reports to departmental leadership.
- Maintains departmental database(s) (education, certifications, and schedules).
- Takes and transcribes, prepares, copies, and distributes meeting minutes as required.
- Assists with special projects and interdepartmental needs when appropriate.
- Performs other duties as assigned.
