HEDIS Coordinator

Sunshine Health; Orlando (FL); Remote; USD 55,000 - 99,000; Full time

Job summary

A leading healthcare organization in Florida is seeking a Coordinator to ensure HEDIS data accuracy and reporting. You will assist with quality improvement initiatives and collaborate with providers on rate investigations. The ideal candidate will have a Bachelor's degree and 3 years of related experience. Competitive benefits and a remote work option are available.

Benefits

Health insurance

401K and stock purchase plans

Tuition reimbursement

Paid time off

Qualifications

• 3+ years of quality improvement or healthcare related experience.
• Working knowledge of the National Committee on Quality Assurance (NCQA) and HEDIS requirements.

Responsibilities

• Ensure HEDIS data accuracy and reporting.
• Establish and maintain action plans to improve HEDIS scores.
• Conduct quality audits and manage HEDIS projects.

Skills

Quality improvement

Healthcare experience

Auditing skills

Data management

Education

Bachelor's degree in related field

Job description

You could be the one who changes everything for our 28 million members. Centene is transforming the health of our communities, one person at a time. As a diversified, national organization, you’ll have access to competitive benefits including a fresh perspective on workplace flexibility.

• This position is open to remote employees in the state of FL**
  
  

Position Purpose Perform duties to ensure HEDIS data accuracy and reporting, including investigation, auditing, and improvement opportunities. Assist with quality improvement initiatives in the service and clinical areas.

• Coordinate, complete, and update management on clinical quality metrics and HEDIS processes and results.
• Establish and maintain an action plan to improve HEDIS scores.
• Implement process to request and evaluate member compliance reports for each HEDIS measure, including evaluating improvement opportunities.
• Collaborate with providers and internal departments on rate investigation and validation activities, including maintaining all evidences, documentations, and changes.
• Manage the HEDIS project to include assignment of nurses, adherence to plan timeline, and vendor oversight for timeliness and quality.
• Conduct quality audit and maintain all data and process controls to ensure compliance.
• Performs other duties as assigned.
• Complies with all policies and standards.
  
  

Education/Experience Bachelor’s degree in related field or equivalent experience. 3+ years of quality improvement or healthcare related experience. Working knowledge of the National Committee on Quality Assurance (NCQA). HEDIS requirements preferred.

Pay Range $55,100.00 - $99,000.00 per year

Centene offers a comprehensive benefits package including competitive pay, health insurance, 401K and stock purchase plans, tuition reimbursement, paid time off plus holidays, and a flexible approach to work with remote, hybrid, field or office work schedules. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law, including full-time or part-time status. Total compensation may also include additional forms of incentives. Benefits may be subject to program eligibility.

Centene is an equal opportunity employer that is committed to diversity, and values the ways in which we are different. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or other characteristic protected by applicable law.

Qualified applicants with arrest or conviction records will be considered in accordance with the LA County Ordinance and the California Fair Chance Act

Seniority level

• Seniority level

  Not Applicable

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  Hospitals and Health Care and Insurance

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