POSITION TITLE: HEDIS Coordinator
DEPARTMENT: Health Improvement
FLSA STATUS: Non - Exempt, 1099 Contract
REPORTS TO: Director, Health Improvement
EVALUATION DATE: 11/2012
This position is a 1099 Contract position beginning January 16, 2013 and ending May 15, 2013.
San Francisco Health Plan (SFHP) seeks an energetic, organized and technologically-savvy coordinator to help measure the quality of preventive and chronic care services SFHP members receive. The primary responsibilities of this position is coordinating the retrieval of medical record reviews to identify whether SFHP members received necessary services per national clinical guidelines and entering data into a database. Some of the services include diabetes tests, immunizations, and annual visits. HEDIS ( Healthcare Effectiveness Data and Information Set) training will be provided. The candidate should be able to work 40 hours per week from January 16, 2013 to May 15, 2013. Key partners for this position are SFHP colleagues in Medical Management and in other SFHP departments, and providers in our network. The Coordinator role requires a deep commitment to better health care, particularly primary care.
ESSENTIAL DUTIES & RESPONSIBILITIES
In collaboration with SFHP staff, the Lead HEDIS Coordinator and the Lead HEDIS Nurse, provides administrative support for the HEDIS pursuit process
Develops and maintains systems for storing and tracking HEDIS medical record documentation
Scans and enters medical record findings into HEDIS database
Calls provider offices and hospitals to request medical records
Calls members to identify date and provider of HEDIS service
Performs clerical functions as necessary, including but not limited to, scheduling meetings, photocopying, mailings and filing
Communicates significant findings, including potential risk management issues, to the Health Improvement Department in a timely manner
Provides written evaluation of data collection and data entry processes with ideas for improvement
Contributes to the achievement of the SFHP mission, goals, and objectives.
Acts with integrity, honesty and fairness, remaining mindful of the duty of trust SFHP has in its employees. Carries these values into work with our members, providers, and employers.
Accepts and adapts to changes in SFHP policy, procedures, and practice quickly and positively; supports colleagues in adapting to changes in the workplace.
Contributes to team discussions, sharing knowledge and expertise willingly.
Organized and detail-oriented
Self motivated with strong time management and multi-tasking abilities.
Displays a courteous, patient, and helpful attitude
CORE COMPETENCIES / KNOWLEDGE & SKILL REQUIREMENTS
Strong time management, project management, and organization skills across multiple simultaneous projects.
Produce accurate and precise work.
Find and fix problems.
Work independently and as part of a team.
Manage projects, develop work plans, prepare budgets.
Hold self and others accountable to deadlines.
Problem-solving skills with the ability to formulate and communicate recommendations for improvement
Strong verbal communication skills, for effective work with SFHP staff, management, and executives; and with health care providers and practice staff.
Strong written communication skills, for powerful succinct messages for busy people within SFHP and provider network. Editing and proofreading skills.
Preferred: familiarity with the Model for Improvement, health care, managed care terminology, Medi-Cal.
EDUCATION, EXPERIENCE & TRAINING REQUIRED
At least one year of experience in health plan operations, health care clinical quality improvement, direct patient care, or other experience directly related to position duties and knowledge.
ESSENTIAL FUNCTIONS – PHYSICAL POSITION REQUIREMENTS; MACHINES AND/OR EQUIPMENT USED
PC literacy required; MSOffice skills (Outlook, Word, Excel, PowerPoint)
Regularly required to operate standard office equipment (personal computer, photocopy machine, fax machine, etc.)
Ability to work on a computer up to 7 hours a day.
Regularly required to sit for long periods of time, occasionally stand and walk.
Regularly required to use hands to operate computer and other office equipment.
Close vision required for computer usage.
Occasionally required to stoop, kneel, climb and lift up to 25 pounds.
Standard office environment without unpleasant or hazardous conditions. Work entails typical physical demands involved in office work. May require occasional weekend and/or evening work.
NOTE: This description is not intended to be construed as an exhaustive list of duties, responsibilities or requirements for the position. This position may change or assume additional duties at any time. The employee may be requested to perform different or additional duties as assigned.