Remote HEDIS & Quality Specialist

GlobalHealth; Oklahoma City (OK); On-site; USD 32,000 - 52,000; Full time

Job summary

GlobalHealth is seeking a detail-oriented Quality Improvement Coordinator to support outreach initiatives and ensure adherence to CMS quality measures. The role involves data entry in HEDIS and related systems, reviewing medical records, and aiding provider education to improve patient care.

Ideal candidates have a High School diploma (or equivalent) and Oklahoma CMA or health-plan experience. Travel up to 75% is required; strong organizational and communication skills are essential.

Qualifications

• High School diploma or equivalent.
• Current Certified/Registered Medical Assistant in State of Oklahoma or six months of experience with a health plan or within a quality department or clinical setting required.
• Valid state Drivers License, reliable personal vehicle and proof of personal vehicle liability insurance required.
• Computer literate and familiar with Microsoft applications (Word, Excel).
• Basic electronic health record knowledge and ability to quickly learn new software.
• Detailed knowledge of quality performance measures and clinical health care.
• Strong organizational and time management skills.
• Strong verbal and written communication skills.

Responsibilities

• Supports and maintains outreach initiatives with members and providers.
• Educates providers on quality metric guidelines to enhance patient compliance.
• Performs accurate data entry in HEDIS software system and outreach tracking system.
• Reviews and maintains medical records to identify, confirm, and/or document referrals, results, and appropriate medical coding.
• Conducts record audits at remote provider offices.
• Maintains detailed technical understanding of HEDIS, CAHPS, HOS, and Meaningful Use measures set by CMS performance standards.
• Must maintain confidentiality of business information, including Protected Health Information (PHI), as required by HIPAA and company policy.
• Performs other duties as assigned.

Skills

Data entry

Microsoft Word/Excel

Verbal communication

Written communication

HIPAA compliance

Education

High School diploma or equivalent

Tools

HEDIS software

Outreach tracking system

Electronic Health Record (EHR)

Job description

GlobalHealth is seeking a detail-oriented Quality Improvement Coordinator to support outreach initiatives and ensure adherence to CMS quality measures. The role involves data entry in HEDIS and related systems, reviewing medical records, and aiding provider education to improve patient care.

Ideal candidates have a High School diploma (or equivalent) and Oklahoma CMA or health-plan experience. Travel up to 75% is required; strong organizational and communication skills are essential.