Regional Quality & HEDIS Coordinator

Sky Mavis; Salem (OR); Hybrid; USD 30,000 - 36,000; Full time

Job summary

P3 Health Partners is hiring a Regional Quality Coordinator to manage quality initiatives and drive HEDIS gap closures across assigned markets. You will coordinate with clinics, providers, and pharmacies, and engage patients for education and engagement on preventative care.

Role requires problem solving, data tracking, and cross-functional collaboration, with a hybrid in-office schedule and pay range aligned to experience and region.

Qualifications

• High school diploma/GED required, associate degree in related field or equivalent experience preferred.
• 2+ years experience in healthcare-related fields required; clinical health care, managed care or Health plan experience strongly preferred.
• Experience with Microsoft Word, Excel, Power Point, Outlook and general office equipment such as copier, fax machine, required.
• Experience in Electronic Health Records required.
• Medical Assistant Certification or experience as a Pharmacy Tech, Radiology Tech, Lab Tech or similar strongly preferred.
• Experience with data mining is preferred.
• Medical terminology knowledge required, CPT II codes experience preferred.

Responsibilities

• Understands CMS, HEDIS, NCQA, Health Plan Quality Standards, CAHPS, HOS, and HIPAA principles.
• Supports Quality Management by working with members and providers to improve quality via HEDIS, CMS Star Rating, and related reporting.
• Performs telephonic outreach to patients, providers, and pharmacies to discuss optimization opportunities.
• Improves patient experience and transitions for better healthcare outcomes.
• Participates in data collection through medical record and claims surveillance.
• Works to maximize performance on quality measures via telehealth and coordination with caregivers.
• Assists in planning, implementing, and executing quality improvement projects.
• Leads Quality Fairs, Diabetic Days, and P3 events to close quality gaps.
• Interacts with health plans and providers with exceptional customer service.

Skills

HEDIS knowledge

Telephonic outreach

Data collection

Project management

HIPAA compliance

Quality reporting

Education

High school diploma or GED

Associate degree in healthcare

Medical Assistant Certification (preferred)

Tools

Microsoft Word

Excel

PowerPoint

Outlook

Job description

P3 Health Partners is hiring a Regional Quality Coordinator to manage quality initiatives and drive HEDIS gap closures across assigned markets. You will coordinate with clinics, providers, and pharmacies, and engage patients for education and engagement on preventative care.

Role requires problem solving, data tracking, and cross-functional collaboration, with a hybrid in-office schedule and pay range aligned to experience and region.