HEDIS Coordinator

Driscoll Children's Hospital; Corpus Christi (TX); On-site; USD 70,000 - 90,000; Full time

Job summary

Driscoll Children's Hospital in Corpus Christi, TX seeks an HEDIS Coordinator to lead data-driven quality initiatives, HEDIS reporting, and ECDS measures, collaborating with internal teams and external stakeholders.

This role requires a bachelor's degree and proficiency with Microsoft Office; experience with HEDIS audits is preferred to improve data capture and regulatory compliance.

You will develop training materials, monitor performance, and sustain program success across the organization.

Qualifications

• Bachelor’s degree in health administration, business administration, information systems, health care, or health-related field is required.
• Proficiency with Microsoft Office products (Word, Excel, Outlook, PowerPoint).
• Two years of experience with HEDIS audit processes is preferred.
• Knowledge of NCQA specifications for HEDIS audits and data quality concepts is a plus.

Responsibilities

• Leads and collaborates in management of complex clinical data acquisition and implementation activities.
• Coordinates annual HEDIS reporting including ECDS measures and data validation.
• Ensures compliance with regulatory, accreditation, and contractual requirements for audits.
• Develops training materials, tools, and resources for stakeholders on data sources and reporting.
• Disseminates audit results and collaborates with committees and practice groups.
• Applies analytics to identify populations and optimize data capture for quality initiatives.

Skills

Project management

Stakeholder collaboration

Data analysis

Healthcare compliance

Education

Bachelor’s degree in health administration, business administration, information systems, health care, or health-related field

Tools

HEDIS ECDS reporting tools

Data integration platforms

Job description

General Purpose of Job

The HEDIS Coordinator is responsible for the identification, initiation, development, implementation, validation, and sustainability of data, work processes, and initiatives intended to enhance the availability and use of electronic clinical data as it relates to DHP Quality performance metrics. This position reports to the Manager of Performance Metrics and works with internal and external stakeholders to develop, implement, monitor, and report quality initiatives and business processes which drive quality data capture.

Essential Duties and Responsibilities

• Maintains the utmost level of confidentiality at all times.
• Adheres to Health System and Health Plan policies and procedures.
• Demonstrates business practices and personal actions that are ethical and adhere to corporate compliance and integrity guidelines.
• Demonstrates a high degree of independence, flexibility, initiative, and commitment.
• Leads and collaborates in the project management of complex clinical data acquisition and implementation activities. This includes coordination with internal and external stakeholders, preparedness for annual HEDIS¨ reporting, including HEDIS® Electronic Clinical Data Systems (ECDS) measures, and providing ongoing support to sustain the optimal results of the project.
• Partners with internal stakeholders to ensure that DHP is compliant with regulatory, accreditation, and contractual requirements for HEDIS® Audit and other quality activities to maximize administrative data capture and leverage efficiencies to minimize provider administrative burden.
• Develops training materials, tools, and educational resources to improve stakeholder understanding and knowledge of supplemental data sources, ECDS reporting, ECDS measures and methodology, and new technologies to maximize data capture.

Collaborates with internal and external stakeholders to disseminate initiatives and audit results, including providers/practice groups, and committees.

• Applies analytics from the Provider Performance Platform and other internal sources to identify and target specific populations/providers to maximize quality interventions to optimize administratively captured performance data.
• Facilitates identification and integration of clinical data from data aggregators, internal health plan data sources, health information exchanges (HIE) and other relevant vendor platforms to improve accuracy, completeness, and availability of electronic clinical data.
• Coordinates with the Data Analytics and Data Integration teams to gather and validate data needed for modeling and analysis to support departmental and organizational quality strategies and needs.
• Maintains knowledge of industry trends and standards, including but not limited to National Committee for Quality Assurance (NCQA) and HEDIS® technical specifications.
• Performs other duties as requested.

Education and Experience

Bachelor’s degree in health administration, business administration, information systems, health care, or a health‑related field is required. Candidates should be proficient in Microsoft Office products, including Word, Excel, Outlook, and PowerPoint.

Preferred Qualifications

• Master’s degree in a health‑related field preferred.
• Knowledge of National Committee on Quality Assurance (NCQA) specifications for HEDIS® audits, the managed care environment, and the basic tenets of quality improvement is strongly preferred.
• Two years of experience with HEDIS® audit processes, including familiarity with supplemental clinical data, Electronic Clinical Data Systems (ECDS) reporting methodology, and experience with validating HEDIS® data sources is preferred.
• Experience with Medicaid or Medicare benefit programs preferred.