HEDIS & Care Coordination Specialist (Bilingual)

Borinquen-Health-Care-Center,-Inc; Miami (FL); On-site; USD 42,000 - 64,000; Full time

Benefits offered by this job

Medical coverage

Dental coverage

Vision coverage

Short-term disability

Job summary

Borinquen Medical Centers in Miami, FL seeks a full-time HEDIS Specialist to coordinate quality projects, manage patient rosters, and schedule appointments to support HEDIS & P4P measures. You will verify demographic and insurance data, collaborate across departments, and report outcomes to the QI Manager to improve care continuity.

The role requires bilingual communication, strong organizational skills, and experience with health plan reporting and data entry in an E.H.R. system.

Qualifications

• Bachelor’s degree required.
• Minimum 1 year of customer service experience.
• Bilingual in Spanish and/or Creole preferred.
• Ability to interact with patients, administration, and staff.

Responsibilities

• Coordinate HEDIS quality projects and align with strategy and goals.
• Obtain patient rosters from participating health plans.
• Call registered patients to schedule appointments and assess quality data.
• Validate rosters, schedule visits, and ensure quality measure compliance.
• Track quality measures and promote BHCC services as needed.
• Support with care management activities and group visits.
• Audit records for HEDIS/NCQA standards and ensure data accuracy.
• Provide data reports to QI Manager; communicate findings clearly.

Skills

Bilingual Spanish/Creole

Customer service

Interpersonal skills

Data entry

Education

Bachelor’s Degree

Tools

Microsoft Office

Outlook

Word

Excel

Job description

Borinquen Medical Centers in Miami, FL seeks a full-time HEDIS Specialist to coordinate quality projects, manage patient rosters, and schedule appointments to support HEDIS & P4P measures. You will verify demographic and insurance data, collaborate across departments, and report outcomes to the QI Manager to improve care continuity.

The role requires bilingual communication, strong organizational skills, and experience with health plan reporting and data entry in an E.H.R. system.