HEDIS Quality Coordinator: Medication Adherence & Outreach

Doctors HealthCare Plans, Inc.; Miami (FL); On-site; USD 42,000 - 56,000; Full time

Job summary

Doctors HealthCare Plans, Inc. is seeking a dedicated outreach specialist in Miami to support adherence initiatives and close HEDIS gaps. You will contact members, providers, and pharmacies to ensure prescriptions are filled and regimens followed, while collaborating with Pharmacy and Provider Relations teams.

Strong communication and data skills are essential. The role requires English/Spanish bilingual ability, HIPAA compliance, and experience with EMRs.

Qualifications

• High school diploma or equivalent; Associate/Bachelor preferred
• 2+ years healthcare setting experience in outreach or care coordination desirable
• Experience with member outreach, customer service, or care coordination preferred
• Knowledge of HEDIS measures and Medicare/Medicaid quality programs preferred
• Understanding of medication adherence concepts and pharmacy operations a plus
• Excellent verbal and interpersonal communication skills for phone outreach
• Comfort with high-volume outbound calls to members, providers, and pharmacies
• Proficient with Microsoft Office; experience with healthcare data systems/EMRs
• Strong attention to detail and time management; able to work cross-functionally
• Bilingual in English/Spanish required

Responsibilities

• Conduct outbound calls to members to encourage adherence and close HEDIS gaps
• Educate members on medication adherence and address barriers
• Contact providers to obtain prescriptions and clarify regimens
• Coordinate with pharmacies to verify status and resolve access issues
• Collaborate with Pharmacy, Provider Relations, and vendors on adherence efforts
• Assist with data analysis of adherence data to guide outreach strategies
• Document interactions in designated systems and escalate issues
• Monitor outreach outcomes and support continuous improvement
• Maintain HIPAA compliance and confidentiality

Skills

Outbound calls

Healthcare outreach

HEDIS knowledge

Excel

HIPAA familiarity

Bilingual English/Spanish

Communication skills

Data analysis

Education

High school diploma

Associate/Bachelor preferred

Tools

EMR systems

Microsoft Excel

Job description

Doctors HealthCare Plans, Inc. is seeking a dedicated outreach specialist in Miami to support adherence initiatives and close HEDIS gaps. You will contact members, providers, and pharmacies to ensure prescriptions are filled and regimens followed, while collaborating with Pharmacy and Provider Relations teams.

Strong communication and data skills are essential. The role requires English/Spanish bilingual ability, HIPAA compliance, and experience with EMRs.