HEDIS & Care Coordination Quality Specialist

CMP01 Mount Sinai Medical Center of Florida, Inc.; United States; On-site; USD 60,000 - 75,000; Full time

Benefits offered by this job

Health benefits

Life insurance

Long-term disability

Healthcare spending accounts

Retirement plan

Paid time off

Pet Insurance

Tuition reimbursement

Employee assistance program

Wellness program

On-site housing

Job summary

Mount Sinai Medical Center is seeking a qualified professional to support the Wellness & Preventive Management program, focusing on HEDIS data abstraction and care-coordination tasks across outpatient settings in South Florida.

You will review records, identify improvements to HEDIS measures, collaborate with leadership, and ensure timely data uploads to health plans. A CMA or RMA certification and a high school diploma are preferred, with a BS degree welcome.

Qualifications

• Certification as CMA or Registered Medical Assistant preferred.
• High School Diploma required.
• Bachelor of Sciences or related field preferred.
• One year of care coordination experience in outpatient settings (HMO/MSO/ACO) preferred.

Responsibilities

• Support Wellness & Preventive Management Program (WPM) including HEDIS.
• Abstract clinical data elements for HEDIS reporting.
• Identify improvements impacting HEDIS measures.
• Review noncompliant reports and flag charts with missing measures.
• Request quality data documentation from outside resources.
• Collaborate with leadership to execute quality strategies.
• Manage reports and monitor performance at group/provider level.
• Engage PCP and clinic staff to close quality gaps.
• Upload HEDIS data to medical records and send to health plan.
• Perform other related duties as assigned.

Skills

HEDIS data abstraction

Care coordination

Quality reporting

Provider engagement

Education

High School Diploma

Bachelor of Sciences degree

Tools

EHR systems

Health Information Systems

Job description

Mount Sinai Medical Center is seeking a qualified professional to support the Wellness & Preventive Management program, focusing on HEDIS data abstraction and care-coordination tasks across outpatient settings in South Florida.

You will review records, identify improvements to HEDIS measures, collaborate with leadership, and ensure timely data uploads to health plans. A CMA or RMA certification and a high school diploma are preferred, with a BS degree welcome.